Seminars In Thrombosis And Hemostasis[JOURNAL]
Sun
200 papers
Thrombotic Complications in Hemophilia: An Intricate Conundrum.
Franchini M, Focosi D, Mannucci PM
Semin Thromb Hemost · 2026 Mar · PMID 40341996 · Publisher ↗
Hemophilia A and hemophilia B are rare genetic disorders characterized by low plasma levels of coagulation factor VIII or factor IX, resulting in a bleeding tendency with a clinical severity proportional to the degree of...
Hemophilia A and hemophilia B are rare genetic disorders characterized by low plasma levels of coagulation factor VIII or factor IX, resulting in a bleeding tendency with a clinical severity proportional to the degree of the clotting factor deficiency. Although rare, hemophilia patients can paradoxically experience thrombotic events that complicate the clinical picture and the management by physicians operating at hemophilia treatment centers. Such thromboembolic complications, which can involve either the arterial or the venous districts, recognize various causes, including aging (due to the progress of care during the last three decades) and inherited and acquired (treatment-related) risk factors. These determinants often interact with each other to increase patients' susceptibility to thrombosis. In this narrative review, we summarize the current knowledge on the mechanisms, clinical presentation, and management of thrombotic complications in hemophilia patients.
Rethinking Platelet and Plasma Transfusion Strategies for Neonates: Evidence, Guidelines, and Unanswered Questions.
Sokou R, Gounari EA, Lianou A … +5 more , Tsantes AG, Piovani D, Bonovas S, Iacovidou N, Tsantes AE
Semin Thromb Hemost · 2026 Feb · PMID 40334700 · Publisher ↗
The transfusion of platelets and fresh frozen plasma (FFP) to critically ill neonates in neonatal intensive care units (NICUs) is a common intervention, yet it is still widely performed without adhering to international...
The transfusion of platelets and fresh frozen plasma (FFP) to critically ill neonates in neonatal intensive care units (NICUs) is a common intervention, yet it is still widely performed without adhering to international guidelines. The guidance itself on the therapeutic management of neonatal coagulation disorders is generally limited due to the absence of strong indications for treatment and is mainly aimed at the prevention of major hemorrhagic events such as intraventricular hemorrhage (IVH) in premature neonates. Historically, the underrepresentation of neonates in clinical studies related to transfusion medicine had led to significant gaps in our knowledge regarding the best transfusion practices in this vulnerable group and to a wide variability in policies among different neonatal units, often based on local experience or guidance designed for older children or adults, and possibly increasing the risk of inappropriate or ineffective interventions. Platelet transfusion and, particularly, FFP administration have been linked to potentially fatal complications in neonates and thus any decision needs to be carefully balanced and requires a thorough consideration of multiple factors in the neonatal population. Despite recent advances toward more restrictive practices, platelet and FFP transfusions are still subject to wide variability in practices.This review examines the existing literature on platelet and FFP transfusions and on the management of massive hemorrhage in neonates, provides a summary of evidence-based guidelines on these topics, and highlights current developments and areas for ongoing and future research with the aim of improving clinical practices.
Impact of Viral Infections on the Hemostatic System.
Marietta M, Coluccio V, Cordella S … +1 more , Luppi M
Semin Thromb Hemost · 2026 Apr · PMID 40334699 · Publisher ↗
The coronavirus disease 2019 (COVID-19) pandemic has brought renewed attention to the significant but often overlooked impact of viral infections on the hemostatic system. This review explores the pathophysiological mech...
The coronavirus disease 2019 (COVID-19) pandemic has brought renewed attention to the significant but often overlooked impact of viral infections on the hemostatic system. This review explores the pathophysiological mechanisms underlying the interaction between viruses and hemostasis, directly through viral components or immune-mediated processes. Viruses are recognized as pathogen-associated molecular patterns (PAMPs) by pattern recognition receptors (PRRs) on innate immune cells such as neutrophils, monocytes, and platelets. This recognition triggers immune responses, including the production of type I interferons (IFN-α and IFN-β) and proinflammatory cytokines like interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), which recruit immune cells and induce pyroptotic cell death. Inflammatory cytokines contribute to endothelial dysfunction and coagulation activation, interacting with platelets, neutrophils, neutrophil extracellular traps (NETs), and the kallikrein-kinin system. Hyperactivation of the cytokine system, known as the "cytokine storm," correlates with disease severity. Common features of viral infections include platelet activation and endotheliitis, leading to thrombocytopenia and microvascular thrombosis. Interestingly, similar pathogenic mechanisms in COVID-19 and viral hemorrhagic fevers (VHFs) result in contrasting clinical manifestations. While COVID-19 predominantly induces a thrombotic response characterized by endothelial damage, platelet hyperactivity, and complement activation, VHFs typically lead to hemorrhagic complications due to thrombocytopenia, consumptive coagulopathy, and vascular injury. These differences are influenced by the timing and location of coagulation activation, as well as the dynamics of immune responses. In COVID-19, coagulation initially occurs in the lungs, followed by systemic thrombotic phases, whereas VHFs rapidly progress to consumptive coagulopathy with hemorrhage, compounded by immune suppression.
Risk Factors of Catheter-Related Thrombosis in Elderly Patients with Lung Cancer Based on Thromboelastography: A Retrospective, Case-Control Study.
Hu J, Xu B, Yao N … +9 more , Peng S, Lv J, Yu H, Hou J, Shi Z, Wang J, Huang X, Ma G, Zhang J
Semin Thromb Hemost · 2026 Jun · PMID 40315871 · Publisher ↗
Catheter-related thrombosis (CRT) poses serious risks for cancer patients. Identifying risk factors and implementing targeted interventions can prevent CRT. To explore thromboelastogram parameters and clinical risk facto...
Catheter-related thrombosis (CRT) poses serious risks for cancer patients. Identifying risk factors and implementing targeted interventions can prevent CRT. To explore thromboelastogram parameters and clinical risk factors for CRT in elderly lung cancer patients. A total of 663 elderly lung cancer patients were selected from three hospitals in Hunan, Hainan, and Qinghai provinces in China from January 1, 2022, to June 30, 2024. The patients were divided into two groups: a CRT group (221 patients) and a non-CRT group (442 patients), with a ratio of 1:2. A between-group comparison and binary logistic regression were used to analyze risk factors for CRT in elderly lung cancer patients. Binary logistic regression analysis showed that decreased (odds ratio [OR]: 0.849, 95% confidence interval [CI]: 0.763-0.945, = 0.003), decreased (0.571, 95% CI: 0.404-0.807, = 0.001), advanced age (OR: 1.073, 95% CI: 1.033-1.113, < 0.001), elevated platelet count (OR: 1.006, 95% CI: 1.004-1.009, < 0.001), increased hemoglobin level (OR: 1.020, 95% CI: 1.009-1.031, < 0.001), shortened PT (OR: 0.904, 95% CI: 0.830-0.985, = 0.022), surgery ≤ 1 month (OR: 2.258, 95% CI: 1.420-3.590, = 0.001), male sex (OR: 4.534, 95% CI: 2.815-7.304, < 0.001), diabetes (OR: 2.478, 95% CI: 1.373-4.472, = 0.003), hypertension (OR: 2.386, 95% CI: 1.505-3.784, < 0.001), physical activity disorders (OR: 9.038, 95% CI: 4.462-18.309, < 0.001) were independent risk factors for CRT in elderly lung cancer patients. Independent risk factors for CRT in elderly lung cancer patients include decreased -values and decreased -values, shortened PT, advanced age, elevated platelet count, increased hemoglobin level, surgery ≤ 1 month, male sex, diabetes, hypertension, and physical activity disorders.
Deep Vein Thrombosis in Adults with HIV: A Systematic Review and Meta-analysis of Prevalence and Risk Factors.
Ismail A, Olawumi AL, Abdulkadir Z … +6 more , Kana SA, Adamu F, Yusuf AA, Jalo RI, Tsiga-Ahmed FI, Aliyu MH
Semin Thromb Hemost · 2025 Oct · PMID 40280167 · Full text
Deep vein thrombosis (DVT) is a preventable yet serious complication among people living with human immunodeficiency virus (PLWH), attributed to hypercoagulability, low CD4+ counts, and antiretroviral therapy. Despite th...
Deep vein thrombosis (DVT) is a preventable yet serious complication among people living with human immunodeficiency virus (PLWH), attributed to hypercoagulability, low CD4+ counts, and antiretroviral therapy. Despite the high burden of human immunodeficiency virus (HIV), data on DVT in this population remain scarce, particularly in high-prevalence regions. This study systematically reviews the prevalence, risk factors, and outcomes of DVT in adults with HIV. Following PRISMA guidelines, we extracted data from 23 studies (180,495 participants) and conducted subgroup analyses based on country, continent, study design, and quality. Heterogeneity and publication bias were assessed statistically. The global DVT prevalence among PLWH was 14%, with Africa reporting the highest prevalence (47%) and Europe the lowest (3%). Kenya exhibited the highest country-specific prevalence (74%), whereas the Netherlands and Denmark had the lowest (2%). Cross-sectional studies reported the highest prevalence (16%). Identified risk factors included hospitalization, opportunistic infections, malignancies, and comorbidities such as hypertension and diabetes. Funnel plot asymmetry indicated potential publication bias and small-study effects. DVT poses a significant health burden among PLWH, particularly in Africa. Given the high prevalence and associated risk factors, integrating DVT prevention and management into HIV care is critical. Targeted interventions should focus on modifiable risk factors and enhanced diagnostic strategies to improve patient outcomes. Future studies should address knowledge gaps and methodological variations to guide better prevention and treatment approaches.
Comparison of Platelet Function Tests for Long-Term Cardiovascular Events after Percutaneous Coronary Interventions.
Zhou M, Hou P, Liang Y … +6 more , Tao W, Guo Z, Zhang B, Lu Y, Chu G, Li P
Semin Thromb Hemost · 2025 Nov · PMID 40280166 · Publisher ↗
Patients with high on-treatment platelet reactivity (HTPR) undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) face increased risks of major adverse cardiovascular events (MACEs). Althou...
Patients with high on-treatment platelet reactivity (HTPR) undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) face increased risks of major adverse cardiovascular events (MACEs). Although platelet function tests like thrombelastography (TEG), vasodilator-stimulated phosphoprotein (VASP), PL-11, and VerifyNow have been described, the correlation between them and their prognostic implications remains uncertain. This prospective study aims to evaluate the consistency and effectiveness of four platelet function detection methods in predicting long-term MACEs in patients with ACS. All 98 ACS patients undergoing PCI with clopidogrel were assessed for HTPR using four platelet function detection methods. The endpoint was the occurrence of MACEs, including cardiac death, nonfatal myocardial infarction (MI), and target vessel revascularization (TVR). Among 98 patients enrolled from April 1, 2014 to June 30, 2014, 27 (27.6%) patients with VerifyNow-detected HTPR (P2Y12 reaction units [PRUs] >240). The incidence of HTPR was 58.2% for TEG, 52% for VASP, and 13.3% for PL-11. VerifyNow and TEG showed the highest consistency in detecting HTPR (kappa = 0.201, = 0.015). During a median follow-up of 6.1 years, 29 MACEs occurred, including 24 TVRs, 3 cardiovascular deaths, and 2 nonfatal MIs. VerifyNow-detected HTPR independently predicted long-term MACEs (hazard ratio: 5.73, 95% confidence interval: 2.04-16.09, = 0.001), even after adjusting for traditional risk factors (TRFs). Receiver operating characteristic (ROC) analysis indicated that the model incorporating TRFs and VerifyNow-detected HTPR had superior predictive discrimination for MACEs (area under ROC curve = 0.889). VerifyNow-detected HTPR independently emerges as a robust predictor for long-term MACEs, demonstrating superior predictive discrimination compared with other platelet function tests.
Magnetic Resonance Screening for Cerebral Venous Sinus Thrombosis during Treatment with Pegaspargase.
Zhang X, Fu Y, Wang H … +7 more , Zhu X, Yu Y, Jiang J, Cao P, Qian X, Shen C, Zhai X
Semin Thromb Hemost · 2025 Oct · PMID 40280165 · Publisher ↗
In children with leukemia, cerebral venous sinus thrombosis (CVST) has a significant incidence and mortality rate, which may interfere with the chemotherapy process and lead to long-term neurological complications. Howev...
In children with leukemia, cerebral venous sinus thrombosis (CVST) has a significant incidence and mortality rate, which may interfere with the chemotherapy process and lead to long-term neurological complications. However, large studies and population-based data on CVST in children are scarce. This study aims to characterize pediatric CVST associated with pegaspargase (PEG-ASP) and evaluate the significance of magnetic resonance venography (MRV) screening following induction remission in acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL). We present a retrospective cohort of a total of 27 children with CSVT and ALL/LBL. The study covers a 4-year period for MRV screening following induction remission and an 8-year comparison period, involving 716 children treated at the Department of Hematology, Children's Hospital of Fudan University. The detection rate of CVST significantly increased after MRV screening (8.4% vs. 1.6%, < 0.01). Over half (58%) of the CVST cases were asymptomatic. Male (84% vs. 52%, = 0.008), immune subtype of T (37% vs. 10%, = 0.001) and higher initial platelet counts (196.25 ± 140.67 vs. 112.49 ± 115.62, = 0.02) patients were more likely to develop CVST. The common symptoms were headache (56%), seizures (31%), vomiting (13%), lethargy (13%), coma (6%), hallucinations (6%), and schizophrenia (6%). Symptomatic patients had a higher likelihood of transverse sinus involvement (75% vs. 9%, = 0.006). Asymptomatic patients had shorter treatment durations (25.5 ± 16.7 weeks vs. 51.6 ± 25.8 weeks, = 0.02) and fewer long-term complications (50% vs. 0%, = 0.02). Thromboelastographic amplitude values at 30 minutes after maximum amplitude were significantly higher in symptomatic patients (49.4 ± 13.2 vs. 35.1 ± 8.3, = 0.01). This study highlights a significant incidence of PEG-ASP-related CVST in children, with MRV screening revealing a notably higher detection rate than previously reported. Most cases were asymptomatic, which demonstrated better prognoses, emphasizing the importance of MRV for early CVST diagnosis after induction remission in ALL/LBL.
Unusual Comorbid Conditions in Three Children with Congenital Dysfibrinogenemia: Lymphedema, Leukemia, and Sternal Defect.
Kaya Z, Özdemir O, Kayhan G … +1 more , Akdemir Ö
Semin Thromb Hemost · 2025 Sep · PMID 40280164 · Publisher ↗
Abstract loading — click title to view on PubMed.
The Co-Occurrence of Low-Frequency Pathogenic Variants in TBXA2R Exacerbating the Hemorrhagic Symptoms in Siblings with Hemophilia B.
Shimomura M, Mizoguchi Y, Kajihara K … +5 more , Sakura F, Noma K, Fujii T, Kobayashi M, Okada S
Semin Thromb Hemost · 2026 Feb · PMID 40245930 · Publisher ↗
Abstract loading — click title to view on PubMed.
The ABO Blood System and Associated Implications for Hemostasis and Thrombosis.
Petrou E, Donta AM, Mellou S … +7 more , Tsalas S, Tsantes AG, Bethanis DA, Kriebardis A, Kyriakou E, Sokou R, Tsantes AE
Semin Thromb Hemost · 2026 Feb · PMID 40239701 · Publisher ↗
The relationship between non-O blood groups and thromboembolic events has been suggested by several studies, although the exact underlying mechanisms are not fully elucidated. However, the correlation between ABO blood g...
The relationship between non-O blood groups and thromboembolic events has been suggested by several studies, although the exact underlying mechanisms are not fully elucidated. However, the correlation between ABO blood groups with the opposite pole of hemostasis, hemorrhage, has been investigated less thoroughly. Non-O blood groups confer an overall increased risk of single, recurrent, and provoked thromboembolic episodes. On the other hand, blood group O has been associated with more severe bleeding events and less favorable manifestations in individuals with hemorrhagic disorders. Therefore, ABO blood group screening may have a role in both thrombotic and hemorrhagic risk assessment and could potentially be added to available clinical prediction systems. This strong belief is supported by the ongoing research. Nevertheless, up to date, the majority of studies represent important heterogeneity, and given the frequency of non-O blood groups, a natural reluctance to incorporate blood groups in risk assessment models arises. Therefore, a more targeted approach should be considered to provide safe outcomes. The in vitro estimation of the thrombotic and hemorrhagic profile of each blood group separately, the quantitative estimation of VWF, FVIII, and platelet function in several disease settings and in well-organized studies, could be useful to establish a clear relationship of ABO blood types with hemostatic and thrombotic disorders. This may ensure a safe approach to categorizing a patient's risk, managing treatment, and influencing prognosis.
Clinical Features of Antiphospholipid Syndrome with Intracardiac Mass.
Xie H, Sun Q, Liu M … +3 more , Xu Y, Wu Q, Li D
Semin Thromb Hemost · 2025 Oct · PMID 40203887 · Publisher ↗
Antiphospholipid syndrome (APS), a disorder characterized by the presence of antiphospholipid antibodies, is commonly associated with thrombotic events and pregnancy complications. Although cardiac involvement of APS is...
Antiphospholipid syndrome (APS), a disorder characterized by the presence of antiphospholipid antibodies, is commonly associated with thrombotic events and pregnancy complications. Although cardiac involvement of APS is very common, intracardiac thrombus is rare and easily misdiagnosed. In order to reduce missed diagnosis and misdiagnosis, we investigated the clinical features of APS with intracardiac mass by summarizing 50 cases (1 newly presented case and 49 additional cases collected from PubMed from 1985 to the present). There were 10 males and 40 females, with ages ranging from 8 to 75 years (median age 35.5). Intracardiac masses were distributed in four cardiac chambers. Mass size ranged from a diameter of 0.5 to 7.1 cm. Clinical manifestations were heterogeneous, including dyspnea, fever, hemiparesis, limb ischemia, and other nonspecific symptoms. In 41 cases with available pathology results, 33 cases were confirmed as thrombus, 2 cases as myxoma, 3 cases as non-bacterial endocarditis, 2 cases as fibrous tissue, and 1 case as inflammatory necrosis. Among 41 cases, 18 cases were suspected of primary cardiac tumors preoperatively, while pathological examination revealed none was tumor. APS patients with intracardiac masses are extremely rare, mostly seen in young or middle-aged people, and they present with a variety of clinical manifestations. Most masses disappear following medical treatment. APS can be accompanied by cardiac myxomas. APS should be promptly investigated in young patients presenting with thrombotic events without any underlying risk factors.
Prediction of Recurrent Venous Thromboembolism and Arterial Cardiovascular Events after Discontinuation of Anticoagulation: The R-VTE-predict and MACE-predict Risk Scores.
Noumegni SR, Espinasse B, Didier R … +6 more , Mao RL, Moreuil C, Tromeur C, Moigne EL, Roux PL, Couturaud F
Semin Thromb Hemost · 2025 Oct · PMID 40203886 · Publisher ↗
Patients who had venous thromboembolism (VTE) are not only at increased risk of recurrent VTE but also of major adverse cardiovascular events (MACEs) than the general population. Therefore, the prediction of the risk of...
Patients who had venous thromboembolism (VTE) are not only at increased risk of recurrent VTE but also of major adverse cardiovascular events (MACEs) than the general population. Therefore, the prediction of the risk of these events is important for a tailored prevention and mitigation strategy. We aimed to develop simple scores to estimate recurrent VTE and MACE risks after the discontinuation of anticoagulation in a large cohort of individuals who suffered VTE (EDITH cohort). The primary endpoints were recurrent symptomatic VTE and MACE (composite of non-fatal acute coronary syndrome, stroke and cardiovascular death). Arterial thrombotic event (ATE) exclusively was also considered. Independent predictors of main outcomes were derived from multivariable Cox regression models. Weighted integer points based on the effect estimate of identified predictors were used to derive the final risk scores. A total of 1,999 participants (mean age: 54.78 years, 46.4% male, 43.6% unprovoked VTE) were included in the derivation cohort and 10,000 in the validation cohort (built using bootstrapping). During a median post-anticoagulation follow-up of 6.9 years, recurrent VTE occurred in 29.5% of participants and MACE in 14.8%. Independent predictors of recurrent VTE were male sex, age >65 years, cancer-associated VTE, and unprovoked VTE (vs. transient risk factor-associated VTE). Independent predictors of MACE were age >65 years, cancer-associated VTE, hypertension, renal insufficiency, and atrial fibrillation. The risk of recurrent VTE (moderate vs. low: hazard ratio [HR]: 2.62, 95% confidence interval [CI]: 2.06-3.34; high vs. low: HR: 3.78, 95% CI: 2.91-4.89), MACE (moderate vs. low: HR: 6.37, 95% CI: 3.19-12.69; high vs. low: HR: 12.32, 95% CI: 6.09-24.89), and ATE (based on MACE-predict risk score) increased gradually from the lowest to highest of the respective prediction risk score groups. These results were confirmed in the validation cohort with overall reasonable models' discrimination performance (recurrent VTE C-statistic: 0.62-0.63, MACE and ATE C-statistic: 0.72-0.77). Contemporary simple risk scores based on readily available clinical characteristics can reasonably predict the risk of recurrent VTE and MACE after the discontinuation of anticoagulation. These findings may influence the choice of anticoagulation strategy after the acute phase of VTE and, therefore, need confirmation by further studies.
Autoantibodies in Autoimmune Coagulation Factor Deficiencies: A Review of Inhibitory and Clearance-Accelerating Mechanisms from Japanese Practice.
Ichinose A
Semin Thromb Hemost · 2025 Sep · PMID 40199519 · Publisher ↗
Autoimmune acquired coagulation factor deficiency (AiCFD) represents a rare coagulation disorder that primarily affects older people and sometimes causes fatal bleeding; therefore, clinicians need to consider this when e...
Autoimmune acquired coagulation factor deficiency (AiCFD) represents a rare coagulation disorder that primarily affects older people and sometimes causes fatal bleeding; therefore, clinicians need to consider this when encountering patients with unexplained bleeding. AiCFD is caused by the production of autoantibodies against one's own coagulation factor, which markedly inhibit its function, or accelerate its clearance from plasma, resulting in hemostatic failure. The plasma of affected patients shows various abnormal findings, because anti-coagulation factor autoantibodies are polyclonal, and each clone has different properties. First, inhibitor type autoantibodies target the functional sites of coagulation factors, thereby considerably reducing their activity. Second, clearance-accelerating autoantibodies bind to non-functional sites and cause rapid removal of coagulation factors from the blood, thereby reducing their levels (and their activity in parallel). Third, mixed type autoantibodies (inhibitory clearance-accelerating) substantially reduce coagulation factor activity and level to various degrees. Most anti-coagulation factor autoantibodies are inhibitory clearance-accelerating types, although pure inhibitor types remain clinically significant; however, the pure clearance-accelerating type appears to be rare, possibly because the autoantibody is not detected unless it exceeds the level of the target coagulation factor (pseudo-autoantibody negative). Moreover, anti-factor XIII autoantibodies are particularly complex, as they interfere with the A subunit (Aa type), its activated form (Ab type), and/or the B subunit (B type). Of the three types, Aa type anti-factor XIII autoantibodies contain a mixture of different inhibitor type autoantibodies in various ratios in plasma, resulting in an extremely diverse range of test findings. Therefore, care must be taken when diagnosing and assessing the efficacy of treatment.
Thrombin Generation Assays: What are the Current Clinical Applications?
Tripodi A, Clerici M, Scalambrino E … +1 more , Peyvandi F
Semin Thromb Hemost · 2026 Jun · PMID 40194527 · Publisher ↗
The thrombin generation assay (TGA), originally developed by McFarlane and Biggs in 1956, was modified in the 2000s by Hemker and coworkers. TGA aims to monitor the continuous generation of thrombin upon activation of co...
The thrombin generation assay (TGA), originally developed by McFarlane and Biggs in 1956, was modified in the 2000s by Hemker and coworkers. TGA aims to monitor the continuous generation of thrombin upon activation of coagulation in plasma by the addition of such triggers as small amounts of tissue factor, synthetic phospholipids, and calcium chloride. TGA is sensitive to hypo- and hypercoagulability and is affected by prohemostatic as well as antithrombotic drugs. The review of the current literature shows that TGA is mainly used to investigate conditions characterized by hypo- as well as hypercoagulability and as a laboratory tool to elucidate coagulation mechanisms that are not yet completely understood. This article aims to overview the value and limits of current procedures for TGA for the investigation of hemostasis.
Hemostatic and Inflammatory Biomarkers are Associated with Functional Limitations after Venous Thromboembolism: A Prospective Cohort Study.
Steiner D, Nopp S, Hoberstorfer T … +4 more , Schlager O, Pabinger I, Weber B, Ay C
Semin Thromb Hemost · 2025 Oct · PMID 40185254 · Full text
Functional limitations often persist in patients with venous thromboembolism (VTE). The relevance of biomarkers for these outcomes remains unexplored. Therefore, we aimed to investigate the association of hemostatic, inf...
Functional limitations often persist in patients with venous thromboembolism (VTE). The relevance of biomarkers for these outcomes remains unexplored. Therefore, we aimed to investigate the association of hemostatic, inflammatory, and cardiovascular biomarkers with functional limitations 3 months after VTE. We conducted a prospective cohort study, including patients with acute VTE within 21 days of diagnosis. Biomarker levels (D-dimer, fibrinogen, factor VIII [FVIII], von Willebrand factor antigen [VWF], C-reactive protein [CRP], troponin T, N-terminal pro-B-type natriuretic peptide [proBNP]) were measured at inclusion and 3 months. Functional limitations at 3 months were evaluated with the post-VTE functional status (PVFS) scale (0-4, higher indicating more limitations). The association of biomarkers with functional limitations was assessed with proportional odds models adjusted for confounders. Furthermore, we evaluated the area under the receiver operating characteristic curve (AUC-ROC) for the presence of slight-to-severe functional limitations. Overall, we included 290 patients (41.4% of women) with a median age of 54.9 years (interquartile range [IQR]: 43.1-64.2). D-dimer, fibrinogen, FVIII, VWF, and CRP measured at inclusion were independently associated with functional limitations at 3 months. VWF showed the most favorable AUC-ROC (0.62, 95% CI, 0.55-0.69). In patients with pulmonary embolism, troponin T and proBNP were not associated with functional limitations. At the 3-month follow-up, D-dimer was the only biomarker independently associated with functional limitations, yielding an area under the curve (AUC) of 0.62 (95% CI, 0.55-0.69). In conclusion, we identified biomarkers independently associated with functional limitations 3 months after VTE. Our results indicate a role of these biomarkers in the early identification of patients at risk of persistent functional limitations and suggest their involvement in the underlying mechanisms.
Comments to the International Council for Standardization in Hematology Guidance for New Lot Verification of Coagulation Reagents, Calibrators, and Controls.
Thelen MHM, van Schrojenstein Lantman M, Stavelin A … +1 more , Loh TP
Semin Thromb Hemost · 2025 Apr · PMID 40174876 · Publisher ↗
Abstract loading — click title to view on PubMed.
Impact of Hematocrit on Coagulation Measured by Rotational Thromboelastometry in Healthy Subjects and Patients with Polycythemia.
Martin M, Nader E, Rezigue H … +6 more , Dargaud Y, Renoux C, Joly P, Heiblig M, Nougier C, Connes P
Semin Thromb Hemost · 2026 Jun · PMID 40169143 · Publisher ↗
Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia, more specifically for those with primary origin. It has been suggested that the high hematocrit (Hct) would favor...
Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia, more specifically for those with primary origin. It has been suggested that the high hematocrit (Hct) would favor hypercoagulability. However, the impact of Hct on coagulation in patients with polycythemia has not been investigated so far. The aim of our study was to compare the coagulation profiles of healthy subjects and patients with polycythemia and to evaluate the in vitro impact of Hct on coagulation. Blood from healthy individuals ( = 100 for blood viscosity; = 19 for coagulation) and patients with primary/secondary polycythemia ( = 29 for blood viscosity; = 20 for coagulation) was used to perform measurements at native Hct. The impact of Hct modulation (20% vs. 50%) on coagulation was tested in vitro in 9 healthy subjects and 19 patients with polycythemia. Blood viscosity was measured by viscosimetry and coagulation and fibrinolysis by rotational thromboelastometry. In patients with polycythemia, Hct, and blood viscosity were higher, clotting time was prolonged and clot lysis was faster compared to healthy individuals. Our in vitro results showed that the clotting time was faster and the clot firmness higher at 20% versus 50% Hct for both populations, without any difference between the two populations at a given Hct. Our findings suggest that the interpretation of thromboelastometry results should be approached with caution in patients with high Hct. The in vivo hypercoagulable state of patients with polycythemia is probably the consequence of changes in hemodynamic conditions attributed to blood hyper-viscosity, that may promote venous stasis and platelet margination.
Anticoagulants in Children with Renal Impairment: A Narrative Review.
Kiskaddon AL, Witt DM, Betensky M … +4 more , Sochet AA, Memken A, Male C, Goldenberg NA
Semin Thromb Hemost · 2025 Oct · PMID 40154508 · Publisher ↗
Venous thromboembolism is a common cause of morbidity and mortality in children with renal disease. To properly treat and prevent thromboembolism in this patient population, it is important to be familiar with the multit...
Venous thromboembolism is a common cause of morbidity and mortality in children with renal disease. To properly treat and prevent thromboembolism in this patient population, it is important to be familiar with the multitude of anticoagulant agents currently available. Many anticoagulant drugs undergo some extent of renal elimination. There are important considerations for the selection, dosing, and monitoring of anticoagulant drugs for patients with renal impairment due to various pharmacokinetic alterations that may occur. While there are data to help guide dosing and monitoring in adults, evidence regarding renal dose adjustment of many anticoagulant drugs in children are limited. For the clinician, anticoagulation management in children with renal impairment presents unique challenges. In addition to considering overall bleeding risk, the extent of renal impairment may vary by patient, making a one-size-fits-all approach to managing these patients difficult. These factors, combined with limited data, can make managing anticoagulation in children with renal impairment a challenge. Therefore, the focus of this review will be to describe the pharmacokinetics of the following anticoagulants in children with impaired renal function: unfractionated heparin, enoxaparin, dalteparin, rivaroxaban, apixaban, edoxaban, fondaparinux, bivalirudin, argatroban, dabigatran, and warfarin.
Novel Antidiabetic Drugs and Risk of Venous Thromboembolism: A Literature Review.
Chen Q, Anijs RJS, Verlaan JPL … +3 more , Scheres LJJ, Klok FA, Cannegieter SC
Semin Thromb Hemost · 2025 Oct · PMID 40154507 · Full text
Novel antidiabetic drugs, particularly sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, have significantly transformed the management landscape for type 2 diabetes...
Novel antidiabetic drugs, particularly sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, have significantly transformed the management landscape for type 2 diabetes mellitus, cardiovascular diseases, and chronic kidney diseases, owing to their well-established cardiorenal protective effects. Given the shared risk factors and comorbidities, it is relevant to consider the potential risk of venous thromboembolism (VTE) in individuals prescribed these novel antidiabetic medications. This literature review aims to summarize currently available evidence on VTE risk associated with novel antidiabetic drugs, including GLP-1 receptor agonists, dipeptidyl-peptidase IV (DPP-4) inhibitors, and SGLT2 inhibitors. Following a comprehensive search on PubMed using relevant keywords and backward reference searching, we identified 25 publications that directly reported on associations between these medications and VTE risk. Findings from these studies, including seven meta-analyses, reveal inconsistent results: some studies suggest that GLP-1 receptor agonists or DPP-4 inhibitors may be associated with increased risk of VTE, whereas SGLT2 inhibitors do not appear to be associated with VTE and may even be a protective factor. A notable limitation of the existing studies is the significant challenge posed by confounding in observational studies, while the randomized controlled trials (RCTs) often concluded with a limited number of VTE events, if it was studied. Furthermore, all identified studies focused on the risk of primary VTE, leaving an important knowledge gap regarding whether these novel antidiabetic drugs may influence the efficacy or safety of anticoagulants used for preventing VTE recurrence. Addressing these gaps presents an important avenue for future research.
Red Blood Cells in Thrombosis: Active Participants in Clot Formation and Stability- A Systematic Review.
Alamin AA, Yahia AIO, Hussien HM
Semin Thromb Hemost · 2026 Jul · PMID 40154506 · Publisher ↗
Thrombosis, the formation of blood clots within blood vessels, has traditionally been attributed to platelets and clotting factors. Red blood cells (RBCs) play a significant role in thrombosis by impacting clot formation...
Thrombosis, the formation of blood clots within blood vessels, has traditionally been attributed to platelets and clotting factors. Red blood cells (RBCs) play a significant role in thrombosis by impacting clot formation, stability, and fibrinolysis through mechanisms such as platelet margination, thrombin generation, and microvesicle release. However, their prothrombotic functions remain insufficiently studied. In this systematic review, which follows PRISMA guidelines, the aim is to explore how RBCs contribute to thrombus formation, stabilization, and resolution. This review analyzed peer-reviewed English-language studies and reviews on RBC involvement in thrombosis, focusing on clot formation, stability, and fibrinolysis. Studies in humans and relevant animal models were included, while case reports, non-English studies, and articles lacking methodological details were excluded. The research commenced in September 2024, utilizing PubMed, Scopus, SpringerLink, and Web of Science databases, with searches conducted up to that date. The risk of bias was assessed using the Newcastle-Ottawa Scale, and data were synthesized qualitatively. A total of 37 studies were included. RBCs contribute to thrombosis by influencing blood viscosity, interacting with platelets, and integrating into clots. Procoagulant activity induced by phosphatidylserine exposure and RBC-derived microvesicle products that promote thrombin generation and clot stability were also identified as key mechanisms. In conclusion, RBCs play an active role in thrombosis formation, contributing to clot formation and stability. Targeting RBC-mediated processes, such as aggregation, deformability, and microvesicle release, may offer novel strategies for thrombosis management. Further research and meta-analyses are needed to refine these therapeutic approaches.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe