Abstract：
BACKGROUND:Minimizing bleeding and transfusion is desirable given its cost, complexity and potential for adverse events. Concerns have been heightened by recent data demonstrating that bleeding events may predict worse outcomes and by warnings about the safety of erythropoietic stimulating agents. Prior small studies suggest that antifibrinolytic agents may reduce bleeding and transfusion need in patients undergoing total hip replacement (THR) or total knee arthroplasty (TKA). However, no single study has been large enough to definitively determine if these agents are safe and effective. To address this issue we performed a systematic review of randomized trials describing the use of tranexamic acid, epsilon aminocaproic acid, or aprotinin administration in the perioperative setting. METHODS:MEDLINE, EMBASE, CINAHL and the Cochrane databases were searched for relevant trials. Two independent reviewers abstracted total blood loss, transfusion requirements, and venous thromboembolism (VTE) rates. Data were combined using the Mantel-Haenszel method and dichotomous data expressed as relative risk (RR) with 95% confidence intervals (CI). RESULTS:Patients receiving antifibrinolytic agents had reduced transfusion need (RR 0.52; 95% CI, 0.42 to 0.64; P<0.00001), reduced blood loss and no increase in the risk of VTE (RR 0.95% CI, 0.80 to 1.10, I(2)=0%, P=0.531). CONCLUSIONS:We conclude that antifibrinolytic agents may reduce bleeding and transfusion in patients undergoing THR or TKA who receive appropriate antithrombotic prophylaxis. There is a need for a large, adequately powered prospective study to carefully examine the safety and efficacy of these agents.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Kagoma YK,Crowther MA,Douketis J,Bhandari M,Eikelboom J,Lim Wdoi
10.1016/j.thromres.2008.09.015subject
Has Abstractpub_date
2009-03-01 00:00:00pages
687-96issue
5eissn
0049-3848issn
1879-2472pii
S0049-3848(08)00452-0journal_volume
123pub_type
杂志文章,meta分析,评审abstract：:Clot dissolution using enzymes from the human fibrinolytic system has long been a goal of physicians and scientists. While recent focus has been on activators of the fibrinolytic system, new data support the use of plasmin itself. This supplement reviews the role of plasmin in fibrinolysis and locally administered pla...
journal_title：Thrombosis research
pub_type：
doi：10.1016/j.thromres.2008.06.008
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:The diagnostic work-up for heparin induced thrombocytopenia (HIT) can take several days. Consequently patients may be speculatively switched onto replacement anticoagulant therapy before a diagnosis is confirmed. On-demand immunoassay diagnostic testing enables timely treatment decisions, based on test resul...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2016.01.025
更新日期：2016-04-01 00:00:00
abstract：:Fasting plasma homocysteine level and the related clinical findings were analysed in 240 consecutive patients with venous thromboembolism. Hyperhomocysteinemia, defined as a plasma level above 20 micromol/l (corresponding to the percentile 95th in the controls), was present in 11.2% of the patients. Plasma homocystein...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(02)00096-8
更新日期：2002-04-15 00:00:00
abstract：:In 1926, Erik von Willebrand, a Finnish physician, published the first manuscript describing a haemorrhagic disorder in people who were living on the Aland islands off the coast of Finland. This disorder is now known by the name of its discoverer. Since this early observation, von Willebrand disease has been extensive...
journal_title：Thrombosis research
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.thromres.2007.03.010
更新日期：2007-01-01 00:00:00
abstract：INTRODUCTION:Preterm infants often require assisted ventilation, however ventilation when applied to the immature lung can initiate ventilator-induced lung injury (VILI). The biotrauma which underscores VILI is largely undefined, and is likely to involve vascular injury responses, including hemostasis. We aimed to use ...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2020.09.036
更新日期：2020-12-01 00:00:00
abstract：INTRODUCTION:Coagulation factor XIII (FXIII) is a fibrin-stabilizing factor, which contributes to hemostasis, wound healing, and maintenance of pregnancy. Accordingly, patients with congenital FXIII deficiency manifest a life-long bleeding tendency, abnormal wound healing and recurrent miscarriage. In order to understa...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2012.05.003
更新日期：2012-09-01 00:00:00
abstract：:A variant of type II von Willebrand disease (vWd) is described in a young woman and her mother with severe lifelong bleeding histories. On electrophoresis with low-resolution agarose gels the plasma of the proband lacked large and intermediate-size multimers of von Willebrand factor (vWF) but the platelet multimeric s...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(92)90165-7
更新日期：1992-02-01 00:00:00
abstract：INTRODUCTION:Lung cancer is the leading cause of cancer-related death worldwide. Small cell lung cancer (SCLC) is thereby a highly aggressive neuroendocrine carcinoma representing about 15% of all lung cancer cases. Due to the highly metastatic behavior and multidrug resistance, the long-term survival of patients is ve...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/S0049-3848(16)30166-9
更新日期：2016-04-01 00:00:00
abstract：BACKGROUND:It is well demonstrated that obesity is an independent risk factor for cardiovascular diseases. Recent studies have shown that obesity, insulin resistance and atherosclerosis are closely related phenomena in which low-grade inflammatory state and prothrombotic condition has pivotal roles. It has been shown t...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2005.12.019
更新日期：2007-01-01 00:00:00
abstract：INTRODUCTION:Although investigation for JAK2 V617F mutation is recommended in patients presenting with splanchnic venous thrombosis (SVT), no specific clinical advice is given to SVT patients presenting without myeloproliferative neoplasms (MPN) and JAK2 V617F mutation. In MPN-free SVT patients, to investigate the clin...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2013.07.014
更新日期：2013-08-01 00:00:00
abstract：:An insertion/deletion (4G/5G) polymorphism in what has been shown to be an enhancer/repressor binding site in the promoter region of the PAI-1 gene has been related to plasma PAI-1 activity. Transfection studies demonstrated increased interleukin-1 stimulated PAI-1 synthesis in cells containing the 4G sequence. To stu...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(98)00132-7
更新日期：1998-12-01 00:00:00
abstract：BACKGROUND:It has been reported that statin therapy produces additional effects including impaired activation of blood coagulation. It is not clear whether statins can affect hemostasis in patients with acute coronary syndrome. The aim of this study was to investigate the effect of prior statin treatment on thrombin ge...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2009.06.021
更新日期：2010-05-01 00:00:00
abstract：:The alpha-chymotrypsin-like proteinase from rat peritoneal mast cells (RMCP I) rapidly destroyed the normal clotting activity of purified, calcium-free, bovine prothrombin, human prothrombin and bovine factor X and simultaneously removed similar N-terminal peptides (Mr approximately 5,000) from both prothrombin and th...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(86)90007-1
更新日期：1986-11-01 00:00:00
abstract：:The experiments in this work were focused on determination of the extent to which fibrinogen component of fibrin glue (Hemaseel HMN, Haemacure Biotech.) retained the conformation of the parent molecule after dry heat antiviral treatment (one hour at 100 degrees C). For this purpose antigenic structure of the fibrinoge...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(96)00084-9
更新日期：1996-05-15 00:00:00
abstract：:We tested whether inhibition of platelet activation by nitric oxide (NO) might be altered by strenuous exercise. Sixteen healthy male non-smokers, aged 20-26 years, underwent treadmill testing. All subjects reached Bruce stage IV without chest pain or abnormal ST-T wave changes. Platelet aggregation by Born's method a...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(97)00162-x
更新日期：1997-09-01 00:00:00
abstract：:It has long been recognised that the function of platelets in health and disease span far beyond their roles in haemostasis and thrombosis. The observation that tumour cells induce platelet aggregation was followed by extensive experimental evidence linking platelets to cancer progression. Aggregated platelets coat tu...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/S0049-3848(12)70013-0
更新日期：2012-04-01 00:00:00
abstract：:Dextran sulfate and polybrene were immobilized on polypropylene tubes with plastic adhesive. Serum albumin was also immobilized on the tube by heat-denaturation. In the those tubes thrombin was protected from inactivation in the presence of 0.1 M NaCl remarkably. Cholesterol coated on the tube also protected the enzym...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(88)90277-0
更新日期：1988-07-01 00:00:00
abstract：:The influence of red blood cells on platelet aggregation has recently been a subject of considerable interest. We have studied the effect of red cells on spontaneously formed platelet aggregates in rotating vials at 37 degrees C. Platelet aggregation was quantified by measuring the fall in number of single platelets w...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(85)90150-1
更新日期：1985-05-01 00:00:00
abstract：BACKGROUND:Arterial calcification is associated with increased risk of cardiovascular events. Osteoprotegerin (OPG) is a cytokine involved in the bone metabolism and vascular calcification. Recent data support a relationship between high serum levels of OPG and increased risk for cardiovascular disease in human. The ai...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2006.12.004
更新日期：2007-01-01 00:00:00
abstract：INTRODUCTION:Thrombomodulin (TM) has been described as a marker of endothelial injury in atherosclerosis. The role of TM as a predictor of PAD severity is to be proven. The goal of the present study is to compare the level of plasmatic (TMp) in patients with intermittent claudication with patients with critical ischemi...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2005.03.010
更新日期：2006-01-01 00:00:00
abstract：:Heparin is an effective, relatively safe, inexpensive parenteral antithrombotic agent widely used in the prevention and treatment of thromboembolic disorders, but it has several limitations such as the marked intra- and inter-patient variability in its anticoagulant response, its poor bioavailability at low doses and ...
journal_title：Thrombosis research
pub_type： 杂志文章,评审
doi：10.1016/j.thromres.2011.11.008
更新日期：2012-03-01 00:00:00
abstract：:The role of protein kinase C (PKC) in platelet activation by thrombin was assessed using a PKC inhibitor Ro 31-7549/001 (R2) which, in vitro, shows more selectivity for PKC than other kinase inhibitors. During early (1.5 s) thrombin-induced platelet activation, when phosphorylation of 47 kDa protein (pleckstrin) and m...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(93)90008-c
更新日期：1993-01-01 00:00:00
abstract：:We have studied the synthesis and subcellular distribution of the glycosylated membrane protein tissue factor (TF) in human blood monocytes and the inducible monocyte like cell line, HL-60. Following induction with endotoxin or the phorbol ester, TPA, tissue factor specific activity was measured in intact cells, sonic...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(87)90405-1
更新日期：1987-11-15 00:00:00
abstract：:Highly purified bovine von Willebrand protein (vWP) has been studied with two complementary techniques. Light scattering measurements on different samples give weight average molecular weights in the range from 7 to 13 million, radius of gyration between 75 and 140 nm and diffusion coefficient near 4.15 X 10(-8) cm2/s...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(85)90289-0
更新日期：1985-11-15 00:00:00
abstract：:Reliable information on what patients with venous thromboembolism (VTE) are at increased risk to die of pulmonary embolism (PE) or bleeding (and the time course of the two fatal events) could likely help to better use anticoagulant therapy by improving selection of patients in whom its benefit will likely outweigh the...
journal_title：Thrombosis research
pub_type： 杂志文章,评审
doi：10.1016/S0049-3848(19)30358-5
更新日期：2019-09-01 00:00:00
abstract：:We examined the effects of polysaccharides on t-PA mediated plasminogen activation using single-chain tissue plasminogen activator (sct-PA) and two-chain tissue plasminogen activator (tct-PA). Unfractionated heparin, low molecular weight heparin (LMW heparin) and dextran sulfates enhanced the activation rate of plasmi...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(91)90021-n
更新日期：1991-06-01 00:00:00
abstract：BACKGROUND:Statins have been shown to have a protective effect for venous thromboembolism (VTE) in the general population. This study sought to assess the association between statins and the risk for cancer-associated deep vein thrombosis (DVT) and pulmonary embolism (PE). METHODS:Patients with newly diagnosed cancer ...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2017.08.001
更新日期：2017-10-01 00:00:00
abstract：INTRODUCTION:To determine whether the HIT IgG class platelet factor 4 (PF4) enzyme immunoabsorbant assay (EIA) influenced the duration of parenteral direct thrombin inhibitor (pDTI) therapy or bleeding risk in patients started on pDTI for a presumed diagnosis of HIT. MATERIALS/METHODS:187 patients started on pDTI for ...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2014.04.030
更新日期：2014-07-01 00:00:00
abstract：:The reunification of Germany in 1990 brought with it major challenges in terms of unifying the care offered to haemophilia patients. At that time, most of the treatment centres belonged to the largest regional hospitals. The centre for paediatric haemophilia patients in Leipzig was at the University Hospital. In this ...
journal_title：Thrombosis research
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.thromres.2013.10.018
更新日期：2014-11-01 00:00:00
abstract：:Concentration-response relationships of human platelet aggregation rates were analyzed for a variety of agonists and inhibitors. Their approximation by the Hill equation showed that the values of the Hill coefficient (h) were agonist-dependent and increased as follows: hADP = hL-EPINEPHRINE = hPAF = hPGH2 = hU46619 le...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(92)90308-w
更新日期：1992-06-01 00:00:00
