Abstract:
:Since the reports by Weismann and Tobin in 1958 and Roberts et al. in 1964 called attention to paradoxical thrombosis in patients treated with heparin, the thrombotic aspect of the heparin-induced thrombocytopenia syndrome (HIT) has been emphasized. Yet to this day, the mechanism of thrombosis associated with HIT (HITT) is unclear. It is important to understand the etiology of HITT because of its devastating clinical consequences. We believe one rational approach to understand the mechanism underlying HITTS is to invoke Virchow's triad: stasis, vascular injury and a hypercoagulable state. A hypercoagulable state exists in all HIT patients due to platelet activation by heparin antibody binding. Thrombin generation from platelet microparticles and exposed platelet phospholipid, coupled with stasis (elderly bedridden or otherwise sedentary ill patients who comprise the majority of the HIT population), provide two risk factors that can lead to venous thrombosis. A hypercoagulable state coupled with endothelial cell dysfunction due to injury from heparin antibody, activated platelets, leukocytes, platelet microparticles, complement, atherosclerosis or medical intervention can lead to arterial thrombosis. Of patients with HIT, HITT occurs in about 25%, suggesting that a second set of patient specific risk factors, in addition to the generation of pathological heparin antibodies, determine whether HITT will develop. Interaction between activated platelets and other platelets, and with endothelial cells, leukocytes, neutrophils, monocytes and cytokines are areas of research that may provide more specific characterization of the hypercoagulable state and vascular damage. Nuances involving genetic variation in platelets, endothelial cells and immune function are also likely to be a major component of the observed variability of this disease spectrum. Virchow's triad may explain the different manifestations of HITTS.
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Walenga JM,Jeske WP,Messmore HLdoi
10.1023/a:1027372901367subject
Has Abstractpub_date
2000-11-01 00:00:00pages
13-20eissn
0929-5305issn
1573-742Xjournal_volume
10 Suppl 1pub_type
杂志文章,评审abstract::Tenecteplase, a mutant form of alteplase, possesses pharmacological properties that might favor its use for emergent fibrinolysis of acute pulmonary embolism. Contemporaneous search of the World's literature reveals 14 humans with acute pulmonary embolism treated with tenecteplase. Here, we summarize those cases and r...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-006-9018-3
更新日期:2007-04-01 00:00:00
abstract::D-dimer levels are increased in patients with acute pulmonary embolism (PE). However, D-dimer levels are also increased in patients with community-acquired pneumonia (CAP). The aim of this prospective cohort study was to examine the incidence and clinical features of patients preliminarily diagnosed with CAP and with ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-015-1275-6
更新日期:2016-05-01 00:00:00
abstract::The impact of platelet parameters on the cardiovascular risk is still debated. Gender differences in platelet volume indexes and turnover have been previously reported, potentially conditioning their role in the development of coronary artery disease (CAD). However, few studies have addressed, so far, the impact of ge...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02080-0
更新日期:2020-05-01 00:00:00
abstract::The authors present a fatal case of late thrombosis of paclitaxel-eluting stent implanted in the left main stem occurring 6 months after the procedure and 3 weeks after the cessation of clopidogrel. An autopsy has shown the lack of endothelization of deployed stent. ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0080-2
更新日期:2008-10-01 00:00:00
abstract::Small portable devices that generate a prothrombin time/INR from fingerstick capillary blood simplify warfarin management by allowing selected patients to monitor and manage their own warfarin dose. Early studies established that patients can self-test at home, with results as accurate as those obtained by practitione...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1023/B:THRO.0000014591.32012.1f
更新日期:2003-08-01 00:00:00
abstract::Several autopsy studies showed microthrombi in pulmonary circulation of severe COVID-19 patients. The major limitation of these investigations is that the autopsy provided static information. Some of these alterations could be secondary to the disseminated intravascular coagulation (DIC) observed as the final standard...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02245-x
更新日期:2020-11-01 00:00:00
abstract::Fibrinogen depletion via catalysis by snake venom enzymes as a therapeutic strategy to prevent or treat thrombotic disorders was utilized for over four decades, with ancrod being the quintessential agent. However, ancrod eventually was found to not be of clinical utility in large scale stroke trial, resulting in the e...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-016-1343-6
更新日期:2016-08-01 00:00:00
abstract::We sought to determine the diagnostic value of a D-dimer test for myocardial infarction (MI). The prospective cohort study was carried in the ED of a university hospital. All included patients were tested for D-dimer and cardiac troponin I (cTnI) on ED admission and additional cTnI 6 h later. AMI was retrospectively c...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-010-0469-1
更新日期:2010-11-01 00:00:00
abstract::The optimal antithrombotic therapy for patients undergoing TAVI with concomitant indication for oral anticoagulation remains unclear. In this high-risk population group, there is a paucity of data with regards to the use of DOACs. In the present study we compared long-term clinical outcomes of TAVI patients requiring ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01968-w
更新日期:2020-07-01 00:00:00
abstract::Cardiac disease following radiation therapy represents a major consideration in the treatment of a variety of malignancies. Damage to the heart can manifest in a variety of pathologies including ischemic cardiac disease, cardiomyopathy, valvular dysfunction, arrhythmias, and pericarditis. This damage has been shown to...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-020-02303-4
更新日期:2020-10-08 00:00:00
abstract::Based on their mode of action, it is reasonable to expect that the combination therapy of aspirin and a vitamin K antagonist (VKA) may be more beneficial in preventing (athero) thrombotic complications in high-risk patients for cardiovascular events. However, there is no consensus about additional aspirin use in the m...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-008-0234-x
更新日期:2009-05-01 00:00:00
abstract::Data comparing the patient characteristics, management and outcomes for dabigatran versus warfarin major bleeding in the practice setting are limited. We performed a retrospective single health system study of atrial fibrillation patients with dabigatran or warfarin major bleeding from October 2010 through September 2...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-015-1213-7
更新日期:2015-10-01 00:00:00
abstract::In this feasibility study, a novel catheter prototype for laser thrombolysis under the guidance of optical coherence tomography (OCT) was designed and evaluated in a preclinical model. Human arteries and veins were integrated into a physiological flow model and occluded with thrombi made from the Chandler Loop. There ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-016-1470-0
更新日期:2017-04-01 00:00:00
abstract::Whitmania pigra Whitman (W. pigra) has been widely employed in decoction for the treatment of blood stasis syndrome for many years in China. The aim of the present study was to explore the anti-venous thrombosis (VT) mechanism of the aqueous extract of W. pigra (AEW) in rats. Rats were orally administered with AEW. A ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02337-8
更新日期:2020-11-17 00:00:00
abstract::Sickle cell disease (SCD) is characterised by abnormal coagulopathy and angiogenesis although their relationships in two common genotypes, homozygous (HbSS) SCD and sickle-haemoglobin C disease (HbSC), are unexplored. We measured markers of platelet activation (soluble P-selectin [sP-selectin]), fibrinolysis (D-dimer)...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0177-7
更新日期:2008-04-01 00:00:00
abstract::The objective of this study were to assess the impact of a quality assurance effort on the door-to-needle time and the choice of thrombolytic agent for the management of acute myocardial infarction in the emergency department. The study design involved a prospective collection of data on a series of consecutive patien...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/A:1008834230015
更新日期:1998-05-01 00:00:00
abstract::The concept of a pulmonary embolism response team (PERT) is multidisciplinary, with the hope that it may positively impact patient care, hospital efficiency, and outcomes in the treatment of patients with intermediate and high risk pulmonary embolism (PE). Clinical characteristics of a baseline population of patients ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01875-0
更新日期:2019-08-01 00:00:00
abstract::Unfractionated heparin (UFH) plasma protein binding and elimination might be impaired in patients with chronic kidney disease (CKD-defined as creatinine clearance <60 ml/min). It is currently unknown at which UFH bolus dose persistent prolongation of activated partial thromboplastin time (aPTT) occurs in ST-segment el...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-015-1255-x
更新日期:2016-04-01 00:00:00
abstract::Warfarin is dependent on multiple hepatic enzymes for metabolism while apixaban is a substrate for P-glycoprotein (P-gp) transport and hepatic CYP3A4 metabolism. The aim of this analysis was to assess the impact of interacting medication use on the treatment effects of apixaban versus warfarin. Outcomes were compared ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11239-019-01823-y
更新日期:2019-04-01 00:00:00
abstract::Little is known about the impact of thrombolytic agents on in-hospital outcomes in the Middle East. The objective of this study was to evaluate the impact of thrombolytic agents on in-hospital outcomes in ST-segment elevation myocardial infarction (STEMI) patients in six Middle Eastern countries. Gulf Registry of Acut...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究
doi:10.1007/s11239-012-0698-6
更新日期:2012-04-01 00:00:00
abstract::Data on LA/LAA thrombus resolution after rivaroxaban treatment has not been established. The aim of the present study was to compare the efficacy and safety on the resolution of LA/LAA thrombus between rivaroxaban and warfarin in nonvalvular atrial fibrillation (AF) patients. 80 AF patients with LA/LAA thrombus betwee...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11239-019-01876-z
更新日期:2019-08-01 00:00:00
abstract::Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging changes in incidence, diagnosis and treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-015-1313-4
更新日期:2016-01-01 00:00:00
abstract::Venous ulcers are the most severe manifestation of post-thrombotic syndrome (PTS). We have previously demonstrated that formation of compact fibrin clots resistant to lysis is observed in patients following deep-vein thrombosis (DVT) who developed PTS. The current study investigated whether unfavourable fibrin clot pr...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01914-w
更新日期:2019-11-01 00:00:00
abstract::Poloxamer 188 is a surfactant with hemorheological, antithrombotic, and neutrophil-inhibitory properties. This agent has been demonstrated to reduce infarct size and to improve left ventricular function in animal models of myocardial infarction and reperfusion, and recently in a randomized trial of patients receiving ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/A:1008848026759
更新日期:1998-07-01 00:00:00
abstract::We assessed the effect of the intercellular mediator of inflammation, platelet activating factor (PAF), on platelet function. The interaction between PAF and the platelet agonists ADP, thrombin and convulxin was analyzed in vitro in whole blood with the use of flow cytometry and was further characterized with the use ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-008-0239-5
更新日期:2009-07-01 00:00:00
abstract::We describe the results of a novel complete care package using point-of-care INR testing and computerized decision support for the management of oral anticoagulation by nurse-led primary care clinics in the United Kingdom. We found such therapy to be as safe and effective as traditional hospital-based care for oral an...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-006-5584-7
更新日期:2006-02-01 00:00:00
abstract::Anticoagulation treatment is effective in preventing both death and recurrence in patients with venous thromboembolism (VTE), but at the same time confers a substantial risk of bleeding complications. The aim of this study was to examine the rate of and predictors for bleeding complications in VTE patients on warfarin...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-015-1305-4
更新日期:2016-02-01 00:00:00
abstract::We have applied the low molecular weight heparin dalteparin as once-daily subcutaneous injections to the treatment of deep vein thrombosis (DVT) on an outpatient basis since 1994. Until today, 377 consecutive patients with DVT below the inguinal ligament have been treated at home with dalteparin. The patients administ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/A:1008866025015
更新日期:1998-09-01 00:00:00
abstract::Infarct artery stenting with adjunctive abciximab therapy is widely used treatment for patients with acute myocardial infarction (AMI). However, bleeding complications have been associated with a worse clinical outcome. Randomized trials in elective patients have shown that postprocedural protamine administration is s...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-010-0481-5
更新日期:2010-11-01 00:00:00
abstract::Patients with carotid atherosclerosis, especially the elderly population, take antithrombotic medicine regularly. However, no previous meta-analysis has focused on one of the possible side effects of such drugs, namely intraplaque hemorrhage (IPH). To determine whether antiplatelet drugs or anticoagulants are associat...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,meta分析
doi:10.1007/s11239-019-01865-2
更新日期:2019-07-01 00:00:00