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https://read.qxmd.com/read/30759794/molecular-research-in-chronic-thromboembolic-pulmonary-hypertension
#1
REVIEW
Isabelle Opitz, Michaela B Kirschner
Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a debilitating disease, for which the underlying pathophysiological mechanisms have yet to be fully elucidated. Occurrence of a pulmonary embolism (PE) is a major risk factor for the development of CTEPH, with non-resolution of the thrombus being considered the main cause of CTEPH. Polymorphisms in the α-chain of fibrinogen have been linked to resistance to fibrinolysis in CTEPH patients, and could be responsible for development and disease progression...
February 12, 2019: International Journal of Molecular Sciences
https://read.qxmd.com/read/30758687/pathophysiology-of-right-ventricular-failure-in-acute-pulmonary-embolism-and-chronic-thromboembolic-pulmonary-hypertension-a-pictorial-essay-for-the-interventional-radiologist
#2
REVIEW
Yolanda C Bryce, Rocio Perez-Johnston, Errol B Bryce, Behrang Homayoon, Ernesto G Santos-Martin
Pulmonary embolus (PE) is the third most common cause of cardiovascular death with more than 600,000 cases occurring in the USA per year. About 45% of patients with acute PE will have acute right ventricular failure, and up to 3.8% of patients will develop chronic thromboembolic pulmonary hypertension (CTEPH) with progressive, severe, chronic heart failure. The right ventricle (RV) is constructed to accommodate a low-resistance afterload. Increases in afterload from acute massive and submassive PE and CTEPH may markedly compromise the RV function leading to hemodynamic collapse and death...
February 13, 2019: Insights Into Imaging
https://read.qxmd.com/read/30704390/nonvalvular-atrial-fibrillation-and-diabetic-nephropathy-epidemiology-prognosis-and-choice-of-anticoagulant-therapy
#3
Natalya A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
November 18, 2018: Kardiologiia
https://read.qxmd.com/read/30678446/hypoalbuminemia-as-a-risk-factor-for-thromboembolic-events-in-inflammatory-bowel-disease-inpatients
#4
Marcello Rabello Imbrizi, Daniela Oliveira Magro, Tirzah de Mendonça Lopes Secundo, Marlone Cunha-Silva, Paulo Gustavo Kotze, Ciro Garcia Montes, Jazon Romilson de Souza Almeida, Virgínia Lúcia Ribeiro Cabral
BACKGROUND/AIMS: Inflammatory bowel disease (IBD) are chronic entities characterized by local and systemic inflammation and may be associated with thrombosis. The aim of this study was to identify the prevalence of thromboembolic events (TEE) in hospitalized IBD patients and identify risk factors for their occurrence. METHODS: This retrospective, single-center study included patients treated at a Brazilian IBD referral unit between 2004 and 2014. Patients hospitalized for more than 48 hours due to active IBD and who did not receive prophylaxis for TEE during hospitalization were included...
January 2019: Intestinal Research
https://read.qxmd.com/read/30675076/all-cause-mortality-amongst-patients-undergoing-above-and-below-knee-amputation-in-a-regional-vascular-centre-within-2014-2015
#5
Gem Kennedy, K McGarry, G Bradley, D W Harkin
Background: Major lower limb amputation remains a common treatment for patients with peripheral vascular disease (PVD) in whom other measures have failed. It has been associated with high morbidity and mortality, including risks from venous thromboembolism (VTE). Methods: A two-year retrospective cohort study was conducted involving 79 patients who underwent major lower limb amputation (below- or above-knee amputation) between January 2014 and December 2015 in a single tertiary referral centre...
January 2019: Ulster Medical Journal
https://read.qxmd.com/read/30645167/genetic-assessment-of-potential-long-term-on-target-side-effects-of-pcsk9-proprotein-convertase-subtilisin-kexin-type-9-inhibitors
#6
Christopher P Nelson, Florence Y Lai, Mintu Nath, Shu Ye, Thomas R Webb, Heribert Schunkert, Nilesh J Samani
BACKGROUND: Although short-term trials have suggested that PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors are safe and reduce risk of cardiovascular diseases, their long-term safety is unclear. Genetic variants associated with lower activity of a gene can act as proxies to identify potential long-term side effects of drugs as recently exemplified by association of LDL (low-density lipoprotein)-lowering variants in the HMGCR (target for statins) and PCSK9 genes with increased risk of type 2 diabetes mellitus (T2DM)...
January 2019: Circulation. Genomic and precision medicine
https://read.qxmd.com/read/30593086/characteristics-and-management-of-patients-with-venous-thromboembolism-the-garfield-vte-registry
#7
Walter Ageno, Sylvia Haas, Jeffrey I Weitz, Samuel Z Goldhaber, Alexander G G Turpie, Shinya Goto, Pantep Angchaisuksiri, Joern Dalsgaard Nielsen, Gloria Kayani, Karen S Pieper, Sebastian Schellong, Henri Bounameaux, Lorenzo G Mantovani, Paolo Prandoni, Ajay K Kakkar
BACKGROUND:  Management of venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), varies worldwide. METHODS:  The Global Anticoagulant Registry in the FIELD - Venous Thromboembolism (GARFIELD-VTE) is a prospective, observational study of 10,685 patients with objectively diagnosed VTE recruited from May 2014 to January 2017 at 417 sites in 28 countries. All patients are followed for at least 3 years. We describe the baseline characteristics of the study population and their management within 30 days of diagnosis...
December 28, 2018: Thrombosis and Haemostasis
https://read.qxmd.com/read/30545970/pathology-and-pathobiology-of-pulmonary-hypertension-state-of-the-art-and-research-perspectives
#8
Marc Humbert, Christophe Guignabert, Sébastien Bonnet, Peter Dorfmüller, James R Klinger, Mark R Nicolls, Andrea J Olschewski, Soni S Pullamsetti, Ralph T Schermuly, Kurt R Stenmark, Marlene Rabinovitch
Clinical and translational research has played a major role in advancing our understanding of pulmonary hypertension (PH), including pulmonary arterial hypertension and other forms of PH with severe vascular remodelling ( e.g. chronic thromboembolic PH and pulmonary veno-occlusive disease). However, PH remains an incurable condition with a high mortality rate, underscoring the need for a better transfer of novel scientific knowledge into healthcare interventions. Herein, we review recent findings in pathology (with the questioning of the strict morphological categorisation of various forms of PH into pre- or post-capillary involvement of pulmonary vessels) and cellular mechanisms contributing to the onset and progression of pulmonary vascular remodelling associated with various forms of PH...
December 13, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://read.qxmd.com/read/30526281/influence-of-antiplatelet-and-anticoagulant-drug-use-on-outcomes-following-chronic-subdural-hematoma-drainage
#9
Michael Tin Chung Poon, Catherine Rea, Angelos G Kolias, Paul M Brennan
We aim to describe the outcomes following CSDH management in a large cohort of patients on antithrombotic drugs, either antiplatelets or anticoagulants, at presentation and to inform clinical decision making on the timing of surgery and recommencement of these drugs. We used data from a previous UK-based multicenter prospective cohort study. Outcomes included recurrence within 60 days, functional outcome at discharge, and thromboembolic event during hospital stay. We performed Cox regression on recurrence and multiple logistic regression on functional outcome...
December 10, 2018: Journal of Neurotrauma
https://read.qxmd.com/read/30522190/-peripheral-small-airway-dysfunction-differences-between-idiopathic-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#10
Q Y An, R Jiang, L Wang, Q H Zhao, S G Gong, J He, C J Luo, M Q Liu, H L Qiu, J Guo, J M Liu
Objective: To investigate the peripheral small airway dysfunction differences between idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods: Impulse oscillmetory system testing (IOS) and pulmonary function testing (PFT) were performed in IPAH and CTEPH patients and 30 healthy control group. We also carried out a subgroup analysis depending on their medical history of airway diseases. Results: We included 42 IPAH and 47 CTEPH patients (with or without airways disease: 8 vs ...
December 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://read.qxmd.com/read/30466848/contribution-of-cardiac-implantable-electronic-devices-to-thrombus-formation-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#11
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
https://read.qxmd.com/read/30346901/therapeutic-approach-to-young-patients-with-low-risk-essential-thrombocythemia-primum-non-nocere
#12
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
https://read.qxmd.com/read/30337447/fibrinogen-and-the-prediction-of-residual-obstruction-manifested-after-pulmonary-embolism-treatment
#13
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
https://read.qxmd.com/read/30321154/-surgical-treatment-of-chronic-thromboembolic-pulmonary-hypertension
#14
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
https://read.qxmd.com/read/30313030/chronic-thromboembolic-pulmonary-hypertension-as-the-first-manifestation-of-nephrotic-syndrome-in-a-12-year-old-child
#15
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)
https://read.qxmd.com/read/30312930/the-prognostic-value-of-interleukin-6-in-multiple-chronic-diseases-and-all-cause-death-the-multi-ethnic-study-of-atherosclerosis-mesa
#16
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
https://read.qxmd.com/read/30277082/pharmacokinetics-of-new-oral-anticoagulants-implications-for-use-in-routine-care
#17
REVIEW
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
https://read.qxmd.com/read/30218829/carotid-artery-entrapment-by-hyoid-bone-a-rare-cause-of-recurrent-strokes-in-a-young-patient
#18
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
https://read.qxmd.com/read/30217344/anticoagulants-in-frail-patients-seven-situations-at-risk
#19
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
https://read.qxmd.com/read/30186045/cosimo-patients-with-active-cancer-changing-to-rivaroxaban-for-the-treatment-and-prevention-of-recurrent-venous-thromboembolism-a-non-interventional-study
#20
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
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