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JOURNAL ARTICLE
Haixiang Yu, Shekhar Kumar, James W Frederiksen, Vladimir N Kolyadko, George Pitoc, Juliana Layzer, Amy Yan, Rachel Rempel, Samuel Francis, Sriram Krishnaswamy, Bruce A Sullenger
Potent and selective inhibition of the structurally homologous proteases of coagulation poses challenges for drug development. Hematophagous organisms frequently accomplish this by fashioning peptide inhibitors combining exosite and active site binding motifs. Inspired by this biological strategy, we create several EXACT inhibitors targeting thrombin and factor Xa de novo by linking EXosite-binding aptamers with small molecule ACTive site inhibitors. The aptamer component within the EXACT inhibitor (1) synergizes with and enhances the potency of small-molecule active site inhibitors by many hundred-fold (2) can redirect an active site inhibitor's selectivity towards a different protease, and (3) enable efficient reversal of inhibition by an antidote that disrupts bivalent binding...
May 10, 2024: Nature Communications
#42
JOURNAL ARTICLE
Chidozie Ukpabi, Ofer Sadan, Yuyang Shi, Kristy N Greene, Owen Samuels, Subin Mathew, Justin Joy, Yajun Mei, William Asbury
BACKGROUND: Optimal pharmacologic thromboprophylaxis dosing is not well described in patients with subarachnoid hemorrhage (SAH) with an external ventricular drain (EVD). Our patients with SAH with an EVD who receive prophylactic enoxaparin are routinely monitored using timed anti-Xa levels. Our primary study goal was to determine the frequency of venous thromboembolism (VTE) and secondary intracranial hemorrhage (ICH) for this population of patients who received pharmacologic prophylaxis with enoxaparin or unfractionated heparin (UFH)...
May 10, 2024: Neurocritical Care
#43
JOURNAL ARTICLE
Jun-Kai Ma, Li-Da Su, Lin-Lin Feng, Jing-Lin Li, Li Pan, Qupei Danzeng, Yanwei Li, Tongyao Shang, Xiao-Lin Zhan, Si-Ying Chen, Shibo Ying, Jian-Rao Hu, Xue Qun Chen, Qi Zhang, Tingbo Liang, Xin-Jiang Lu
Bleeding and thrombosis are known as common complications of polycythemia for a long time. However, the role of coagulation system in erythropoiesis is unclear. Here, we discover that an anticoagulant protein tissue factor pathway inhibitor (TFPI) plays an essential role in erythropoiesis via the control of heme biosynthesis in central macrophages. TFPI levels are elevated in erythroblasts of human erythroblastic islands with JAK2V617F mutation and hypoxia condition. Erythroid lineage-specific knockout TFPI results in impaired erythropoiesis through decreasing ferrochelatase expression and heme biosynthesis in central macrophages...
May 10, 2024: Nature Communications
#44
JOURNAL ARTICLE
Mark Schreuder, Georges Jourdi, Dejvid Veizaj, David A Poole, Ka Lei Cheung, Géraldine Poenou, Daniël Verhoef, Stella Thomassen, Laura F H Janssen, Alain Stepanian, Tilman M Hackeng, Pascale Gaussem, Pieter H Reitsma, Daan P Geerke, Virginie Siguret, Mettine H A Bos
BACKGROUND: Direct oral factor Xa inhibitors are widely used as alternatives to conventional vitamin K antagonists in managing venous thromboembolism and nonvalvular atrial fibrillation. Unfortunately, bleeding-related adverse events remain a major concern in clinical practice. In case of bleeding or emergency surgery, rapid-onset reversal agents may be required to counteract the anticoagulant activity. OBJECTIVES: The ability of factor Xa variants to bypass the direct oral factor Xa inhibitors was assessed...
May 8, 2024: Journal of Thrombosis and Haemostasis: JTH
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JOURNAL ARTICLE
James D Douketis, Qilong Yi, Deepak L Bhatt, Eva Muehlhofer, Michael K Wang, Stuart Connolly, Salim Yusuf, Aldo P Maggioni, John W Eikelboom
BACKGROUND: No study has investigated the perioperative management and clinical outcomes in patients who are receiving rivaroxaban 2.5 mg bid and ASA 81-100 mg daily. METHODS: Sub-analysis of the COMPASS trial to assess perioperative management and clinical outcomes in patients with stable coronary or peripheral artery disease who were randomized to receive rivaroxaban 2.5 mg bid plus ASA 100 mg daily, rivaroxaban 5 mg bid, or ASA 100 mg daily. Patients studied required a surgery/procedure during the trial...
May 8, 2024: Journal of Thrombosis and Haemostasis: JTH
#46
Ioanna Pachi, Aikaterini Theodorou, Georgios Velonakis, Eleni Bakola, Maria Chondrogianni, Alexandra Akrivaki, Konstantinos Palialexis, Stavros Spiliopoulos, Georgios Tsivgoulis
OBJECTIVES: Cerebral venous thrombosis is an uncommon, yet life-threatening condition, affecting mainly young and middle-aged individuals. Moreover, it represents an underrecognised etiology of lobar intracerebral hemorrhage (ICH). The clinical course of CVT is variable in the first days after diagnosis and medical complications including pulmonary embolism (PE) may result in early neurological deterioration and death if left untreated. MATERIALS AND METHODS: Case report...
May 8, 2024: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
#47
JOURNAL ARTICLE
Konstantinos P Letsas, Athanasios Saplaouras, Panagiotis Mililis, Ourania Kariki, George Bazoukis, Stefanos Archontakis, Ioannis Anagnostopoulos, Sokratis Triantafyllou, Lina Palaiodimou, Anastasios Chatziantoniou, Anastasios Lykoudis, Athena Mpatsouli, Georgia Katsa, Olga Kadda, Stylianos Dragasis, Vasileios Cheilas, Eleftheria Garyfalia Tsetika, Dimitrios Asvestas, Panagiotis Korantzopoulos, George Poulos, Themistocles Maounis, Anna Kostopoulou, Charalambos Kossyvakis, Sotirios Xydonas, Georgios Giannopoulos, John Papagiannis, Alexandros Tsoutsinos, George Sidiropoulos, Vassilios Vassilikos, Nikolaos Fragakis, Stylianos Tzeis, Spyridon Deftereos, Polychronis Dilaveris, Skevos Sideris, Michael Efremidis, Georgios Tsivgoulis
AIMS: Implantable loop recorders (ILRs) are increasingly being used for long-term cardiac monitoring in different clinical settings. The aim of this study was to investigate the real-world performance of ILRs-including the time to diagnosis- in unselected patients with different ILR indications. METHODS AND RESULTS: In this multicenter, observational study, 871 patients with an indication of pre-syncope/syncope (61.9%), unexplained palpitations (10.4%), and atrial fibrillation (AF) detection with a history of cryptogenic stroke (CS) (27...
May 8, 2024: Hellenic Journal of Cardiology: HJC
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JOURNAL ARTICLE
Elena Rodríguez-González, Pablo Martínez-Legazpi, Teresa Mombiela, Ana González-Mansilla, Antonia Delgado-Montero, Juan A Guzmán-De-Villoria, Fernando Díaz-Otero, Raquel Prieto-Arévalo, Miriam Juárez, María Del Carmen García Del Rey, Pilar Fernández-García, Óscar Flores, Andrea Postigo, Raquel Yotti, Manuel García-Villalba, Francisco Fernández-Avilés, Juan C Del Álamo, Javier Bermejo
INTRODUCTION AND OBJECTIVES: In the setting of ST-segment elevation myocardial infarction (STEMI), imaging-based biomarkers could be useful for guiding oral anticoagulation to prevent cardioembolism. Our objective was to test the efficacy of intraventricular blood stasis imaging in predicting a composite primary endpoint of cardioembolic risk during the first 6 months after STEMI. METHODS: We designed a prospective clinical study, Imaging Silent Brain Infarct in Acute Myocardial Infarction (ISBITAMI, NCT02917213), including patients with a first STEMI, an ejection fraction ≤ 45% and without atrial fibrillation to assess the performance of stasis metrics to predict cardioembolism...
May 8, 2024: Revista Española de Cardiología
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REVIEW
Pouya Ebrahimi, Babak Sattartabar, Homa Taheri, Parnian Soltani, Pegah Bahiraie, Seyedeh Maryam Mousavinezhad, Mehrdad Gooshvar, Plydoros Kampaktsis, Reza Arsanjani, Mohammad Sahebjam, Kaveh Hosseini, Robert J Siegel
Mechanical prosthetic valve thrombosis (MPVT) is a common complication of valvular implantations. This study compared the efficacy and safety of different treatments for MPVT. A systematic search of electronic databases identified studies evaluating surgical, anticoagulant, and thrombolytic therapies. Although several studies of different types have been conducted to evaluate the efficacy of these treatment strategies the lack of randomized controlled trials has resulted in the inability to make a definitive conclusion about the pros and cons of these treatments...
May 8, 2024: Current Problems in Cardiology
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JOURNAL ARTICLE
Kazuma Yamakawa, Yutaka Umemura, Katsunori Mochizuki, Tadashi Matsuoka, Takeshi Wada, Mineji Hayakawa, Toshiaki Iba, Yasuhiro Ohtomo, Kohji Okamoto, Toshihiko Mayumi, Toshiaki Ikeda, Hiroyasu Ishikura, Hiroshi Ogura, Shigeki Kushimoto, Daizoh Saitoh, Satoshi Gando
BACKGROUND: Japanese Association for Acute Medicine (JAAM) disseminated intravascular coagulation (DIC) criteria were launched nearly 20 years ago. Following the revised conceptual definition of sepsis and subsequent omission of systemic inflammatory response syndrome (SIRS) score from the latest sepsis diagnostic criteria, we omitted the SIRS score and proposed a modified version of JAAM DIC criteria, the JAAM-2 DIC criteria. OBJECTIVES: To validate and compare performance between new JAAM-2 DIC criteria and conventional JAAM DIC criteria for sepsis...
May 10, 2024: Thrombosis and Haemostasis
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JOURNAL ARTICLE
Meredith K D Hawking, Deborah Swinglehurst
We adopt Rapley's (2008) concept of distributed decision making to explore the role of the body in people's decisions to seek medical care. We conducted in-depth interviews with patients diagnosed with atrial fibrillation (AF) who were taking long-term anticoagulants to prevent stroke. We interviewed seventeen patients recruited from English anticoagulant clinics using the biographic-narrative-interpretive method, and conducted thematic, structural and metaphorical analyses. This pluralistic analysis focused on how distributed decision-making was enacted through a range of socio-material, relational and embodied practices...
May 6, 2024: Social Science & Medicine
#52
Suman Biswas, Yasemin Bahar, Abdul Rasheed Bahar, Israel Safiriyu, Sheetal Vasundara Mathai, Adrija Hajra, Rahul Gupta, Wilbert S Aronow
No abstract text is available yet for this article.
May 9, 2024: Current Problems in Cardiology
#53
JOURNAL ARTICLE
Licong Chen, Yuan Liu, Jianhua Jiang, Qi Fang, Quanquan Zhang
RATIONALE: Marfan syndrome (MFS), which is a dominantly inherited connective tissue disease resulting from a mutation in the FBN1 gene, exhibits variable manifestations affecting the cardiovascular, musculoskeletal, ophthalmologic, and pulmonary systems. Notably, neurologic deficiency, which involves ischemic or hemorrhagic stroke, is a rare but severe manifestation. The safety of rt-PA treatment for ischemic stroke caused by MFS is still under discussion. PATIENT CONCERNS: In the current report, we discuss 3 atypical MFS cases presented as acute ischemic stroke, compared to those exhibiting cardiovascular and musculoskeletal abnormalities...
May 10, 2024: Medicine (Baltimore)
#54
JOURNAL ARTICLE
Huazhen Wang, Yingming Zhu, Yongshan Nan, Xianglan Jin
RATIONALE: Anesthesia management of patients with dilated cardiomyopathy (DCM) has always been a challenge for anesthesiologists. Eighty percent of patients with DCM have heart failure as the first symptom, which may be accompanied by arrhythmias, thromboembolism, etc. Thrombosis is a significant contributing factor to adverse cardiovascular and cerebrovascular events, and its risk is severely underestimated in the anesthetic management of DCM. PATIENT CONCERNS: We present a case of a 54-year-old hypersensitive female patient with dilated cardiomyopathy and purpura who underwent an interventional thrombectomy under general anesthesia following a lower limb thromboembolism...
May 10, 2024: Medicine (Baltimore)
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JOURNAL ARTICLE
Hasan Uncu, Tolga Onur Badak, Haci Ali Ucak, Ferid Cereb, Ahmet Cakallioglu
Warfarin, a widely utilized anticoagulant, is paramount for preventing thromboembolic events in patients with mechanical heart valve replacements. However, its narrow therapeutic index can lead to over-anticoagulation and overdose, resulting in serious health risks. This study examines the efficacy of human prothrombin complex concentrate (PCC) in managing warfarin overdose, in comparison with traditional treatments. A retrospective analysis was conducted on 162 adults who presented with warfarin overdose (INR > 5...
May 10, 2024: Medicine (Baltimore)
#56
JOURNAL ARTICLE
Julie Rayes, Alexander Brill
Venous thrombosis (VT) is a serious medical condition in which a blood clot forms in deep veins, often causing limb swelling and pain. Current anti-thrombotic therapies carry significant bleeding risks resulting from targeting essential coagulation factors. Recent advances in this field have revealed that the crosstalk between the innate immune system and coagulation cascade is a key driver of VT pathogenesis, offering new opportunities for potential therapeutic interventions without inducing bleeding complications...
May 10, 2024: Blood
#57
JOURNAL ARTICLE
Emmanuel Häfliger, Basil Kopp, Pauline Darbellay Farhoumand, Damien Choffat, Jean-Benoît Rossel, Jean-Luc Reny, Drahomir Aujesky, Marie Méan, Christine Baumgartner
IMPORTANCE: Thromboprophylaxis is recommended for medical inpatients at risk of venous thromboembolism (VTE). Risk assessment models (RAMs) have been developed to stratify VTE risk, but a prospective head-to-head comparison of validated RAMs is lacking. OBJECTIVES: To prospectively validate an easy-to-use RAM, the simplified Geneva score, and compare its prognostic performance with previously validated RAMs. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study was conducted from June 18, 2020, to January 4, 2022, with a 90-day follow-up...
May 1, 2024: JAMA Network Open
#58
REVIEW
Fabio Fusi, Simona Saponara, Margaret A Brimble, David Rennison, Brian Hopkins, Sergio Bova
Norbormide (NRB) is a Rattus -selective toxicant, which was serendipitously discovered in 1964 and formerly marketed as an eco-friendly rodenticide that was deemed harmless to non- Rattus species. However, due to inconsistent efficacy and the emergence of second-generation anticoagulants, its usage declined, with registration lapsing in 2003. NRBs' lethal action in rats entails irreversible vasoconstriction of peripheral arteries, likely inducing cardiac damage: however, the precise chain of events leading to fatality and the target organs involved remain elusive...
May 6, 2024: Cells
#59
JOURNAL ARTICLE
Hamza Salim, Basel Musmar, Nimer Adeeb, Vivek Yedavalli, Dhairya Lakhani, Sahibjot Singh Grewal, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Joshua D Bernstock, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Xavier Barreau, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Mohammad Ali Aziz-Sultan, Constantin Hecker, Hamza Shaikh, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adrien Guenego, Adam A Dmytriw
BACKGROUND: Stroke remains a major health concern globally, with oral anticoagulants widely prescribed for stroke prevention. The efficacy and safety of mechanical thrombectomy (MT) in anticoagulated patients with distal medium vessel occlusions (DMVO) are not well understood. METHODS: This retrospective analysis involved 1282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2023...
May 10, 2024: European Stroke Journal
#60
JOURNAL ARTICLE
Mattias Tallroth, Ruzan Udumyan, András Büki, Mia von Euler
BACKGROUND: A rapid shift has occurred from vitamin K antagonists toward direct oral anticoagulants, which have a lower risk of intracerebral hemorrhage (ICH). However, effects on clinical outcomes after ICH are understudied. We aimed to describe the prevalence of antithrombotic drugs and to study the prognosis among prestroke functionally independent Swedish patients with ICH. METHODS AND RESULTS: We identified all patients diagnosed with nontraumatic ICH in 2017 to 2021 from the Swedish Stroke Register (n=13 155) and assessed death and functional outcome at 3 months after ICH in prestroke functionally independent patients (n=10 014)...
May 10, 2024: Journal of the American Heart Association
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