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chronic thromboembolism g

Rohith Nayak, Timothy M Fernandes, William R Auger, G Victor Pretorius, Michael M Madani, Ulrika M Birgersdotter-Green
OBJECTIVES: This study aimed to identify the prevalence of cardiac implantable electronic devices (CIEDs) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and to describe the associated disease burden. BACKGROUND: CTEPH is a debilitating disease, now potentially curable with pulmonary thromboendarterectomy (PTE). The contribution of CIEDs to thrombosis in this patient population has not been previously studied. METHODS: The charts of 982 CTEPH patients, who underwent PTE between January 1, 2009, and December 31, 2015 at University of California-San Diego (UCSD) Medical Center, were reviewed for pacemakers or implantable cardioverter defibrillators (ICDs) implanted before surgery...
November 2018: JACC. Clinical Electrophysiology
Lucia Masarova, Srdan Verstovsek
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
October 22, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Benjamin Planquette, Olivier Sanchez, James J Marsh, Peter G Chiles, Joseph Emmerich, Grégoire Le Gal, Guy Meyer, Tanya Wolfson, Anthony C Gamst, Roger E Moore, Gabriel B Gugiu, Timothy A Morris
Residual pulmonary vascular obstruction (RPVO) and chronic thromboembolic pulmonary hypertension (CTEPH) are both long-term complications of acute pulmonary embolism, but it is unknown whether RPVO can be predicted by variants of fibrinogen associated with CTEPH.We used the Akaike information criterion to select the best predictive models for RPVO in two prospectively followed cohorts of acute pulmonary embolism patients, using as candidate variables the extent of the initial obstruction, clinical characteristics and fibrinogen-related data...
November 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
M A Cherniavskiĭ, A G Edemskiĭ, Iu A Kudaev, A M Cherniavskiĭ
Analysed herein are the results of pulmonary endarterectomy (PEA) performed in a total of 169 patients presenting with chronic thromboembolic pulmonary hypertension (CTEPH) at the National Medical Research Centre named after Academician E.N. Meshalkin over the period from 2004 to 2014. Pulmonary endarterectomy was carried out according to the standard technique in the conditions of assisted circulation with the use of hypothermia and circulatory arrest. The duration of follow up of patients after surgical treatment amounted to 10 years...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Fan Ma, Kaiyu Zhou, Yimin Hua, Xiaoliang Liu, Hongyu Duan, Yifei Li, Chuan Wang
RATIONALE: Chronic thromboembolic pulmonary hypertension (CTEPH) is rare in children and determining the underlying etiologies is essential for treatment. Venous thromboembolism, a well-known complication in nephrotic syndrome (NS), always occurrs during the treatment in course of the disease. However, CTEPH as the first manifestation of NS has not been reported till now. PATIENT CONCERNS: A 12-year-old boy initially complained of hemoptysis, cough and shortness of breath with exertion, any symptoms regarding NS such as edema were not presented...
October 2018: Medicine (Baltimore)
Miguel Cainzos-Achirica, Cristina Enjuanes, Philip Greenland, John W McEvoy, Mary Cushman, Zeina Dardari, Khurram Nasir, Matthew J Budoff, Mouaz H Al-Mallah, Joseph Yeboah, Michael D Miedema, Roger S Blumenthal, Josep Comin-Colet, Michael J Blaha
BACKGROUND AND AIMS: We aimed to evaluate the associations and prognostic value of interleukin-6 (IL6) for the prediction of atherosclerotic cardiovascular disease (ASCVD) events, heart failure (HF), and other chronic diseases in a large, multi-ethnic, contemporary population. METHODS: We included 6617 participants from the Multi-Ethnic Study of Atherosclerosis (5640 non-users, 977 users of statins at baseline). Main outcomes were hard ASCVD events and HF; secondary outcomes included all-cause death, atrial fibrillation, venous thromboembolism and cancer...
October 4, 2018: Atherosclerosis
Ylenia Ingrasciotta, Salvatore Crisafulli, Valeria Pizzimenti, Ilaria Marcianò, Anna Mancuso, Giuseppe Andò, Salvatore Corrao, Piera Capranzano, Gianluca Trifirò
Since 2008, new oral anticoagulants (NOACs) have been approved for the prevention of venous thromboembolism (VTE) in patients receiving hip or knee replacement surgery, prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF), treatment of deep vein thrombosis (DVT), and pulmonary embolism (PE). Premarketing randomized clinical trials (RCTs) of NOACs demonstrated their non-inferiority in terms of efficacy vs. warfarin (traditional oral anticoagulant - TOA), with lower risk of serious adverse drug reactions, especially cerebral hemorrhages...
October 2018: Expert Opinion on Drug Metabolism & Toxicology
Anastasia Plotkin, Matthew G Bartley, Kathryn E Bowser, Jeniann A Yi, Gregory A Magee
The search for etiology of stroke in a young patient may present a diagnostic challenge. In rare cases, chronic trauma to the carotid artery may be the cause of cerebral thromboembolic events. The hyoid bone lies in close proximity to the carotid artery bifurcation, and anatomic variants have been implicated in carotid compression, stenosis, dissection, and pseudoaneurysm. We report a case of recurrent strokes in a 32 year-old woman due to an elongated hyoid bone causing thrombus formation in her right internal carotid artery (ICA) resulting in recurrent embolic strokes confirmed on diffusion-weighted magnetic resonance imaging (MRI)...
September 12, 2018: Annals of Vascular Surgery
I Elalamy, O Hanon, G Deray, V Launay-Vacher
In the case of venous thromboembolic disease (VTE), physicians are facing more and more difficulties in managing VTE and their treatment in frail patients. These patients could present several risk situations such as: chronic kidney disease (CKD), underweight or malnourished, falls, cognitive impairment, multi-medicated patients, cancer and pregnancy. Guidelines typically recommend anticoagulation. There are multiple challenges in the safe use of anticoagulation in frail patients, including bleeding risk, monitoring and adherence, and polypharmacy...
September 2018: Journal de médecine vasculaire
Alexander T Cohen, Anthony Maraveyas, Jan Beyer-Westendorf, Agnes Y Y Lee, Lorenzo G Mantovani, Miriam Bach
Background: Around 20% of venous thromboembolism (VTE) cases occur in patients with cancer. Current guidelines recommend low molecular weight heparin (LMWH) as the preferred anticoagulant for VTE treatment. However, some guidelines state that vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) are acceptable alternatives for long-term therapy in some patients if LMWHs are not available. LMWHs and VKAs have a number of drawbacks that can increase the burden on patients...
2018: Thrombosis Journal
F C Roller, S Kriechbaum, A Breithecker, C Liebetrau, M Haas, C Schneider, A Rolf, S Guth, E Mayer, C Hamm, G A Krombach, C B Wiedenroth
OBJECTIVES: The aim of this study was to assess native T1 mapping in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) before and 6 months after balloon pulmonary angioplasty (BPA) and compare the results with right heart function and pulmonary haemodynamics. METHODS: Magnetic resonance imaging at 1.5 T and right heart catheterisation were performed in 21 consecutive inoperable CTEPH patients before and 6 months after BPA. T1 values were measured within the septal myocardium, the upper and lower right ventricular insertion points, and the lateral wall at the basal short-axis section...
August 29, 2018: European Radiology
H P Shen, D W Wu, Y F Chen, N F Lian, C S Xu, G L Lian, M X Yang, C S Deng
Objective: To analyze the relationship between TNF-α and pulmonary vascular remodeling in order to explore the pathogenesis of CTEPH. Methods: Autologous blood clots were repeatedly injected into the left jugular vein of rats to establish the CTEPH model. Then mean pulmonary artery pressure (mPAP), histopathology, the plasma level of TNF-α, and the expressions of mRNA and protein of TNF-α in pulmonary artery were measured. Results: In the experiment group, the mPAP and vessel wall area/total area (WA/TA) ratio gradually increased as emblism extended, and increased significantly compared with the sham operation group...
August 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Frederikus A Klok, Stefano Barco, Alexander G G Turpie, Sylvia Haas, Reinhold Kreutz, Lorenzo G Mantovani, Martin Gebel, Matthias Herpers, Joerg-Peter Bugge, Stavros V Kostantinides, Walter Ageno
Venous thromboembolism (VTE)-BLEED, a decision tool for predicting major bleeding during chronic anticoagulation for VTE has not yet been validated in practice-based conditions. We calculated the prognostic indices of VTE-BLEED for major bleeding after day 30 and day 90, as well as for recurrent VTE and all-cause mortality, in 4457 patients enrolled in the international, prospective XALIA study. The median at-risk time was 190 days (interquartile range 106-360). The crude hazard ratio (HR) for major bleeding after day 30 was 2·6 [95% confidence interval (CI) 1·3-5·2] and the treatment-adjusted HR was 2·3 (95% CI 1·1-4·5) for VTE-BLEED high (versus low) risk patients: the corresponding values for major bleeding after day 90 were 3·8 (95% CI 1·6-9·3) and 3·2 (95% CI 1·3-7·7), respectively...
August 19, 2018: British Journal of Haematology
Tatsuro Ibe, Hiroshi Wada, Kenichi Sakakura, Miyuki Ito, Yusuke Ugata, Kei Yamamoto, Yousuke Taniguchi, Shin-Ichi Momomura, Hideo Fujita
Recently, long-term outcomes of pre-capillary pulmonary hypertension (PH) have been improved, whereas morbidity and mortality are still high because of right-sided heart failure (HF). Right-sided HF is closely related to right ventricular (RV) function and hemodynamics such as RV stroke work index (RVSWI). However, the association between RVSWI and long-term outcomes in pre-capillary PH has not been well investigated. The aims of this study were to compare clinical characteristics between low RVSWI and high RVSWI and to investigate the association between low RVSWI and long-term outcomes in patients with pre-capillary PH...
September 26, 2018: International Heart Journal
S G Kanorskiy
Conducting anticoagulant therapy for atrial fibrillation, combined with diabetes mellitus and/or chronic kidney disease, can create certain difficulties for practicing doctors due to a simultaneous increase in the risk of thromboembolic and hemorrhagic complications. The presence of diabetes mellitus and renal dysfunction can influence the results of antithrombotic therapy in patients with atrial fibrillation. The review provides information on the differences in efficacy and safety of individual oral anticoagulants in the prevention of thromboembolic complications of atrial fibrillation in patients with diabetes mellitus, impaired renal function...
2018: Kardiologiia
Syed Rehan Quadery, Andrew J Swift, Catherine G Billings, Alfred A R Thompson, Charles A Elliot, Judith Hurdman, Athanasios Charalampopoulos, Ian Sabroe, Iain J Armstrong, Neil Hamilton, Paul Sephton, Sian Garrad, Joanna Pepke-Zaba, David P Jenkins, Nicholas Screaton, Alexander M Rothman, Allan Lawrie, Trevor Cleveland, Steven Thomas, Smitha Rajaram, Catherine Hill, Christine Davies, Christopher S Johns, Jim M Wild, Robin Condliffe, David G Kiely
Pulmonary endarterectomy (PEA) is the gold standard treatment for operable chronic thromboembolic pulmonary hypertension (CTEPH). However, a proportion of patients with operable disease decline surgery. There are currently no published data on this patient group. The aim of this study was to identify outcomes and prognostic factors in a large cohort of consecutive patients with CTEPH.Data were collected for consecutive, treatment-naive CTEPH patients at the Pulmonary Vascular Disease Unit of the Royal Hallamshire Hospital (Sheffield, UK) between 2001 and 2014...
September 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
K L Cheung, N A Zakai, P W Callas, G Howard, B K Mahmoodi, C A Peralta, S E Judd, M Kurella Tamura, M Cushman
Essentials Chronic kidney disease (CKD) is associated with procoagulant and inflammatory biomarkers. We studied the association of CKD and venous thromboembolism (VTE) in a case-cohort study. Factor VIII, D-dimer and C-reactive protein appeared to explain the association of CKD and VTE. Statin use was protective against VTE in those with and without CKD. SUMMARY: Background Chronic kidney disease (CKD) is associated with venous thromboembolism (VTE) risk via unknown mechanisms. Whether factors associated with reduced VTE risk in the general population might also be associated with reduced VTE risk in CKD patients is unknown...
September 2018: Journal of Thrombosis and Haemostasis: JTH
C Schwahn-Schreiber, F X Breu, E Rabe, I Buschmann, W Döller, G R Lulay, A Miller, E Valesky, S Reich-Schupke
Under the direction of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and in cooperation with other specialist associations, the S1 guideline on intermittent pneumatic compression (IPC) was adopted in January 2018. It replaces the previous guideline from March 2005. The aim of the guideline is to optimize the indication and therapeutic use of IPC in vascular diseases and edema. An extensive literature search of MEDLINE, existing guidelines, and work relevant to the topic was performed...
August 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Jing Tao, Elena N Bukanova, Shamsuddin Akhtar
Background: Although factor Xa inhibitors have become a popular choice for chronic oral anticoagulation, effective drug reversal remains difficult due to a lack of specific antidote. Currently, 4-factor prothrombin complex concentrate (4F-PCC) is considered the treatment of choice for factor Xa inhibitor-related major bleeding. However, safety of 4F-PCC and its risk of thrombosis when used for this off-label purpose remain unclear. The purpose of this retrospective study is to determine the rate of thromboembolism when 4F-PCC is used for the emergent reversal of factor Xa inhibitors...
2018: Journal of Intensive Care
Damien G Noone, Kazumoto Iijima, Rulan Parekh
The incidence of idiopathic nephrotic syndrome (NS) is 1·15-16·9 per 100 000 children, varying by ethnicity and region. The cause remains unknown but the pathogenesis of idiopathic NS is thought to involve immune dysregulation, systemic circulating factors, or inherited structural abnormalities of the podocyte. Genetic risk is more commonly described among children with steroid-resistant disease. The mainstay of therapy is prednisone for the vast majority of patients who are steroid responsive; however, the disease can run a frequently relapsing course, necessitating the need for alternative immunosuppressive agents...
July 7, 2018: Lancet
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