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Cui X, Xia R, Chao A. Correlation between ABO blood type and lower extremity deep vein thrombosis in elderly patients following hip fracture. Am J Transl Res 2024; 16:2654-2661. [PMID: 39006278 PMCID: PMC11236633 DOI: 10.62347/wkya9182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To examine the correlation between ABO blood type and the incidence of lower extremity deep vein thrombosis (LEDVT) in elderly patients after hip fracture surgery, while identifying contributing factors to thrombogenesis. METHODS We conducted a retrospective analysis of 159 elderly patients with hip fractures treated at Tianjin Hospital (Affiliated Hospital of Tianjin University) from December 2021 to December 2023. The cohort was divided into two groups: those with O blood type (45 patients) and those with non-O blood types (114 patients). We analyzed clinical data and the incidence of LEDVT between the groups. Logistic regression was used to identify independent risk factors for LEDVT, and receiver operator characteristic (ROC) curve analysis evaluated the predictive efficacy of these factors. RESULTS The incidence of LEDVT was significantly higher in the non-O blood type group compared to the O blood type group (34.21% vs. 15.56%, P = 0.0408). Logistic regression identified high body mass index (BMI), comorbid hypertension, low platelet count (PLT), prolonged prothrombin time (PT), and non-O blood type as independent risk factors for LEDVT. The ROC curve for these predictors showed an area under the curve of 0.862, with a sensitivity of 75.22%, a specificity of 86.96%, and an accuracy of 78.62%. CONCLUSION ABO blood type is correlated with the occurrence of LEDVT in elderly patients' post-hip fracture. Those with non-O blood type, alongside other factors such as high BMI, hypertension, low PLT, and extended PT, are at increased risk of developing LEDVT.
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Affiliation(s)
- Xiuli Cui
- Department of Osteo-Internal Medicine, Tianjin Hospital (Affiliated Hospital of Tianjin University) No. 406 Jiefang South Road, Hexi District, Tianjin 300211, China
| | - Ronglin Xia
- Department of Osteo-Internal Medicine, Tianjin Hospital (Affiliated Hospital of Tianjin University) No. 406 Jiefang South Road, Hexi District, Tianjin 300211, China
| | - Aijun Chao
- Department of Osteo-Internal Medicine, Tianjin Hospital (Affiliated Hospital of Tianjin University) No. 406 Jiefang South Road, Hexi District, Tianjin 300211, China
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2
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Khider L, Planquette B, Smadja DM, Sanchez O, Rial C, Goudot G, Messas E, Mirault T, Gendron N. Acute phase determinant of post-thrombotic syndrome: A review of the literature. Thromb Res 2024; 238:11-18. [PMID: 38643521 DOI: 10.1016/j.thromres.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Post-thrombotic syndrome (PTS) is the main long-term complication of deep vein thrombosis (DVT). Several therapies are being evaluated to prevent or to treat PTS. Identifying the patients most likely to benefit from these therapies presents a significant challenge. OBJECTIVES The objective of this review was to identify risk factors for PTS during the acute phase of DVT. ELIGIBILITY CRITERIA We searched the PubMed and Cochrane databases for studies published between January 2000 and January 2021, including randomized clinical trials, meta-analyses, systematic reviews and observational studies. RESULTS Risk factors for PTS such as proximal location of DVT, obesity, chronic venous disease, history of DVT are associated with higher risk of PTS. On the initial ultrasound-Doppler, a high thrombotic burden appears to be a predictor of PTS. Among the evaluated biomarkers, some inflammatory markers such as ICAM-1, MMP-1 and MMP-8 appear to be associated with a higher risk of developing PTS. Coagulation disorders are not associated with risk of developing PTS. Role of endothelial biomarkers in predicting PTS has been poorly explored. Lastly, vitamin K antagonist was associated with a higher risk of developing PTS when compared to direct oral anticoagulants and low molecular weight heparin. CONCLUSIONS Several risk factors during the acute phase of VTE are associated with an increased risk of developing PTS. There is a high-unmet medical need to identify potential biomarkers for early detection of patients at risk of developing PTS after VTE. Inflammatory and endothelial biomarkers should be explored in larger prospective studies to identify populations that could benefit from new therapies.
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Affiliation(s)
- Lina Khider
- Université Paris Cité, Innovative Therapies in Haemostasis, INSERM, Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France.
| | - Benjamin Planquette
- Université Paris Cité, Innovative Therapies in Haemostasis, INSERM, 75006 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France; Respiratory Medicine Department, Assistance Publique - Hôpitaux de Paris, 75015 Paris, France
| | - David M Smadja
- Université Paris Cité, Innovative Therapies in Haemostasis, INSERM, 75006 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France; Hematology Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Olivier Sanchez
- Université Paris Cité, Innovative Therapies in Haemostasis, INSERM, 75006 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France; Respiratory Medicine Department, Assistance Publique - Hôpitaux de Paris, 75015 Paris, France
| | - Carla Rial
- Université Paris Cité, Innovative Therapies in Haemostasis, INSERM, Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Guillaume Goudot
- Université Paris Cité, PARCC, INSERM U970, Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Emmanuel Messas
- Université Paris Cité, PARCC, INSERM U970, Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Tristan Mirault
- Université Paris Cité, PARCC, INSERM U970, Vascular Medicine Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
| | - Nicolas Gendron
- Université Paris Cité, Innovative Therapies in Haemostasis, INSERM, 75006 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France; Hematology Department, Assistance Publique Hôpitaux de Paris, 75015 Paris, France
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Michels A, Lillicrap D, Yacob M. Role of von Willebrand factor in venous thromboembolic disease. JVS Vasc Sci 2022; 3:17-29. [PMID: 35028601 PMCID: PMC8739873 DOI: 10.1016/j.jvssci.2021.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/23/2021] [Indexed: 02/07/2023] Open
Abstract
Objective Evolving evidence of the shared risk factors and pathogenic mechanisms in arterial and venous thrombosis questions of the strict vascular dichotomy of arterial vs venous. The connection between arterial and venous thrombosis has been highlighted by common underlying inflammatory processes, a concept known as thromboinflammatory disease. Using this relationship, we can apply knowledge from arterial disease to better understand and potentially mitigate venous disease. A protein that has been extensively studied in atherothrombotic disease and inflammation is von Willebrand factor (VWF). Because many predisposing and provoking factors of venous thromboembolism (VTE) have been shown to directly modulate VWF levels, it is, perhaps, not surprising that VWF has been highlighted by several recent association studies of patients with VTE. Methods In the present narrative review, we investigated more deeply the effects of VWF in venous disease by synthesizing the data from clinical studies of deep vein thrombosis of the limbs, pulmonary embolism, portal and cerebral vein thrombosis, and the complications of thrombosis, including post-thrombotic syndrome, venous insufficiency, and chronic thromboembolic pulmonary hypertension. We have also discussed the findings from preclinical studies to highlight novel VWF biochemistry in thrombosis and therapeutics. Results Across the spectrum of venous thromboembolic disease, we consistently observed that elevated VWF levels conferred an increased risk of VTE and long-term venous complications. We have highlighted important findings from VWF molecular research and have proposed mechanisms by which VWF participates in venous disease. Emerging evidence from preclinical studies might reveal novel targets for thromboinflammatory disease, including specific VWF pathophysiology. Furthermore, we have highlighted the utility of measuring VWF to prognosticate and risk stratify for VTE and its complications. Conclusions As the prevalence of inflammatory processes, such as aging, obesity, and diabetes increases in our population, it is critical to understand the evolving role of VWF in venous disease to guide clinical decisions and therapeutics.
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Affiliation(s)
- Alison Michels
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.,Division of Cardiovascular Surgery, Queen's University, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - David Lillicrap
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Michael Yacob
- Division of Cardiovascular Surgery, Queen's University, Kingston Health Sciences Centre, Kingston, Ontario, Canada
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Borella E, Spiezia L, Turatti G, Poretto A, Marobin M, Campello E, Simioni P. ABO blood groups and the risk of retinal vein occlusion. Intern Emerg Med 2021; 16:1387-1390. [PMID: 33398610 DOI: 10.1007/s11739-020-02608-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Elisabetta Borella
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Luca Spiezia
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Giacomo Turatti
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Anna Poretto
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Michelangelo Marobin
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Elena Campello
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Paolo Simioni
- General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Via Giustiniani 2, 35128, Padova, Italy.
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Zosel KL, Dummar MK, Adams BG, Henderson NC, Westrick RB. Upper Extremity Superficial Vein Thromboses Presenting as Acute Neck Pain in a Young and Healthy Male: A Case Report. Int J Sports Phys Ther 2021; 16:854-861. [PMID: 34123537 PMCID: PMC8169024 DOI: 10.26603/001c.23429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Neck pain in the United States is pervasive and contributes to disability. While the majority of neck pain in young and healthy individuals is neuromusculoskeletal in nature, screening for red flags is necessary for ruling-out serious medical pathologies. The purpose of this case report is to describe a young and healthy male subject with a primary complaint of acute neck pain with multiple underlying upper extremity superficial vein thromboses (UESVTs). CASE DESCRIPTION The subject was a 27-year-old male active-duty Soldier referred to physical therapy by his primary care provider (PCP) for acute left-sided neck pain. Prior to physical therapy, the subject had been treated with cyclobenzaprine, oxycodone-acetaminophen, trigger point injection and had undergone a D-dimer to rule out a potential thrombus due to air travel and lower extremity immobilization. OUTCOMES The subject underwent a D-dimer, Doppler ultrasound, pharmacological treatment of Rivaroxaban, and was referred to hematology/oncology to rule out systemic causes of SVTs. Evidence of subtle increases in blood pressure over the course of three months, a positive D-dimer, and symptoms incongruent with clinical presentation contributed to referral to a hematology/oncology specialist and a diagnosis of multiple UESVTs. The subject was able to return to his previous level of activity by six months and remained free of SVTs at two-year follow-up. DISCUSSION UESVT events are rare and can be challenging to identify. This case report describes a unique presentation of acute neck pain caused by underlying UESVTs in an otherwise healthy and active young male. LEVEL OF EVIDENCE Level 4.
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Brouns SLN, van Geffen JP, Campello E, Swieringa F, Spiezia L, van Oerle R, Provenzale I, Verdoold R, Farndale RW, Clemetson KJ, Spronk HMH, van der Meijden PEJ, Cavill R, Kuijpers MJE, Castoldi E, Simioni P, Heemskerk JWM. Platelet-primed interactions of coagulation and anticoagulation pathways in flow-dependent thrombus formation. Sci Rep 2020; 10:11910. [PMID: 32680988 PMCID: PMC7368055 DOI: 10.1038/s41598-020-68438-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
In haemostasis and thrombosis, platelet, coagulation and anticoagulation pathways act together to produce fibrin-containing thrombi. We developed a microspot-based technique, in which we assessed platelet adhesion, platelet activation, thrombus structure and fibrin clot formation in real time using flowing whole blood. Microspots were made from distinct platelet-adhesive surfaces in the absence or presence of tissue factor, thrombomodulin or activated protein C. Kinetics of platelet activation, thrombus structure and fibrin formation were assessed by fluorescence microscopy. This work revealed: (1) a priming role of platelet adhesion in thrombus contraction and subsequent fibrin formation; (2) a surface-independent role of tissue factor, independent of the shear rate; (3) a mechanism of tissue factor-enhanced activation of the intrinsic coagulation pathway; (4) a local, suppressive role of the anticoagulant thrombomodulin/protein C pathway under flow. Multiparameter analysis using blood samples from patients with (anti)coagulation disorders indicated characteristic defects in thrombus formation, in cases of factor V, XI or XII deficiency; and in contrast, thrombogenic effects in patients with factor V-Leiden. Taken together, this integrative phenotyping approach of platelet–fibrin thrombus formation has revealed interaction mechanisms of platelet-primed key haemostatic pathways with alterations in patients with (anti)coagulation defects. It can help as an important functional add-on whole-blood phenotyping.
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Affiliation(s)
- Sanne L N Brouns
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Johanna P van Geffen
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Elena Campello
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Frauke Swieringa
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Department of Protein Dynamics, Leibniz Institute for Analytical Sciences, ISAS, Dortmund, Germany
| | - Luca Spiezia
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - René van Oerle
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Isabella Provenzale
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Remco Verdoold
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | | | - Kenneth J Clemetson
- Department of Haematology, Inselspital, University of Berne, Berne, Switzerland
| | - Henri M H Spronk
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Paola E J van der Meijden
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Rachel Cavill
- Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, The Netherlands
| | - Marijke J E Kuijpers
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Elisabetta Castoldi
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Paolo Simioni
- Department of Medicine, University of Padua Medical School, Padua, Italy.
| | - Johan W M Heemskerk
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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Abstract
INTRODUCTION Fifty-three years after the first description of an inherited prothrombotic condition (antithrombin deficiency), our knowledge on hereditary and acquired causes of hypercoagulability that can predispose carriers to venous thromboembolism (VTE) has greatly improved. Areas covered: Main causes of hereditary thrombophilia are summarized alongside new prothrombotic mutations recently discovered. The main causes of acquired thrombophilia, and namely, antiphospholipid antibody syndrome and hyperhomocysteinemia, are also discussed together with other common acquired prothrombotic states characterized by an increase of procoagulant factors and/or a decrease of natural anticoagulants. Finally, suggestions for thromboprophylaxis in carriers of hereditary thrombophilia according to current guidelines/evidence are made for the most challenging high-risk situations (i.e. surgery, pregnancy, contraception, cancer, economy class syndrome) as well as for the prevention of post-thrombotic syndrome. Expert opinion: A carrier of inherited thrombophilia should be evaluated in the framework of other (genetic and/or acquired) coexisting risk factors for first or recurrent VTE when assessing the need and duration of prevention (primary prophylaxis). Prevention strategies should be tailored to each patient and every situational risk factor. The knowledge of the carriership status of severe thrombophilia in the proband can be important to provide asymptomatic relatives with adequate counseling on thrombophilia screening or primary thromboprophylaxis.
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Affiliation(s)
- Elena Campello
- a Haemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED) , Padova University Hospital , Padova , Italy
| | - Luca Spiezia
- a Haemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED) , Padova University Hospital , Padova , Italy
| | - Angelo Adamo
- a Haemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED) , Padova University Hospital , Padova , Italy
| | - Paolo Simioni
- a Haemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED) , Padova University Hospital , Padova , Italy
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