Abstract:
OBJECTIVES:In this randomized management study, we examined the safety of withholding anticoagulation on the basis of negative impedance plethysmography (IPG) compared to negative contrast venography (CV) in symptomatic patients with a first episode of clinically suspected deep vein thrombosis (DVT), and we determined the impact of the limitations of IPG or CV on their clinical utility. METHODS:Patients at a university teaching hospital presenting with a first episode of clinically suspected DVT were randomized to one of two management strategies at study entry: (1) IPG: if positive, confirmatory CV was performed. If CV was positive, anticoagulants were administered, if CV was negative, anticoagulants were held. If negative, IPG was repeated serially and if it remained negative, anticoagulants were held (n = 165). (2) CV: if positive, anticoagulants were administered, if negative, anticoagulants were held (n = 159). The negative predictive value (NPV) of IPG and CV, positive predictive value (PPV) of IPG, and the failure rate of each strategy were assessed. RESULTS:Among IPG patients, 28 of 37 with positive IPG initially or during serial testing and evaluable CV had confirmed DVT (PPV 76%; 95% confidence interval, CI [62%, 90%]). DVT was diagnosed during serial testing in 2.1% of patients with initially negative IPG who completed testing. The NPV overall of negative IPG was 98.3%. During follow-up, two patients in the IPG group (1.2%) and two patients in the CV group (1.3%) developed venous thromboembolism (VTE). Death during follow-up occurred in 11% of IPG patients compared to 6% of CV patients (P =.13) The investigation strategy failed in 25% of IPG patients and in 14% of CV patients. CONCLUSIONS:Our findings demonstrate that the two diagnostic strategies we studied are equivalent methods for ruling out DVT in patients with a first episode of suspected DVT. The PPV of IPG was too low to permit its use alone as a test to rule in DVT. Both strategies had surprisingly high failure rates.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Kahn SR,Joseph L,Grover SA,Leclerc JRdoi
10.1016/s0049-3848(01)00222-5subject
Has Abstractpub_date
2001-04-01 00:00:00pages
15-24issue
1eissn
0049-3848issn
1879-2472pii
S0049-3848(01)00222-5journal_volume
102pub_type
临床试验,杂志文章,随机对照试验abstract::Fibrinogen has been reported to interact with phospholipid; however, the properties of this binding interaction have not been characterized. Purified preparations of human fibrinogen bound to small unilamellar vesicles containing phosphatidylserine (PS) as measured by light scattering and radioisotope filtration. Bind...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(99)00058-4
更新日期:1999-09-15 00:00:00
abstract::Thrombin-activatable fibrinolysis inhibitor (TAFI), also known as procarboxypeptidase U or plasma procarboxypeptidase B, is a relatively recently described plasma glycoprotein synthesised in the liver. It can be activated into active enzyme TAFIa (carboxypeptidase U or plasma carboxypeptidase B) by a complex of thromb...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(02)00072-5
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Elevated soluble urokinase-type plasminogen activator receptor (suPAR) indicates an inflammatory state caused by conditions such as HIV and cancer. Recently suPAR was identified as an indicator of cardiovascular disease (CVD). CVD is highly prevalent in black South Africans, but the potential role of suPAR...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2011.10.034
更新日期:2012-08-01 00:00:00
abstract::The turnover of tissue plasminogen activator (tPA) was studied in rabbits using a double-label technique which allowed the comparison of various tPA derivatives with a standard tPA in individual animals. Purified recombinant tPA (Alteplase) was labelled with 125I and used as a standard for each experiment. Various tPA...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(88)90278-2
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Although patients with idiopathic VTE are at higher than normal risk of asymptomatic atherosclerosis and of cardiovascular events, the impact of cardiovascular risk factors on VTE is poorly understood. OBJECTIVE:To assess the prevalence of the metabolic syndrome and of its components in patients with early-...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2010.12.005
更新日期:2011-03-01 00:00:00
abstract::Epidemiological studies have shown that oral contraceptives increase the risk of thromboembolic disease in susceptible women however the mechanisms involved are unclear. We investigated whole blood platelet aggregation in 44 women randomly allocated to 6 cycles of treatment with either gestodene (75ug) or desogestrel ...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0049-3848(96)00013-8
更新日期:1996-02-15 00:00:00
abstract::Cancer-associated arterial thrombotic events (ATEs) are increasingly recognized in specific malignancies and in association with the expanding armamentarium of novel chemotherapeutic agents. The improved cancer survival led to cardiovascular complications becoming clinically relevant many years after cancer diagnosis....
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2018.01.003
更新日期:2018-04-01 00:00:00
abstract::The present investigation has used an aggregation-disaggregation-reaggregation model to determine if exposure to potent aggregating agents causing a refractory state in deaggregated platelets results in down-regulation and clearance of GPIb/IX, the receptor for von willebrand factor. Thrombin, the thrombin receptor ac...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(96)00185-5
更新日期:1996-11-15 00:00:00
abstract:BACKGROUND:An association between high red cell distribution width (RDW) and venous thromboembolism (VTE) has been observed. However, it is not known whether this association differs within various manifestations of VTE, nor if there is an interaction between RDW and thrombophilia abnormalities on the risk of VTE. AIM...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2015.07.020
更新日期:2015-09-01 00:00:00
abstract::The multiligand receptor, low density lipoprotein receptor-related protein (LRP), is implicated in processes such as atherosclerosis and fibrinolysis through its mediation of the catabolism of lipoproteins, proteases, and protease inhibitor complexes. The hepatoma cell line Hep G2 expresses LRP and has been used widel...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(97)00287-9
更新日期:1997-12-15 00:00:00
abstract:BACKGROUND:Clauss fibrinogen assay (CFA) is widely used as a screening test to detect fibrinogen disorders. However, CFA alone cannot distinguish quantitative and qualitative defects because it depends on functional fibrinogen activity (Ac), and fibrinogen antigen (Ag) determination is required to classify fibrinogen d...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2018.12.018
更新日期:2019-02-01 00:00:00
abstract::Patients who had survived a stroke or transient ischaemic attacks (TIA) were admitted to a trial of low-dose aspirin (50 mg) alone, sustained release dipyridamole (400 mg/day) alone, or a combination of the two agents, and results compared with a placebo over 24 months. This low-dose aspirin regimen produced in pairwi...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0049-3848(98)00099-1
更新日期:1998-09-15 00:00:00
abstract:INTRODUCTION:The Coasys® Plus C (Behnk Elektronik, distributed by Roche Diagnostics) is a coagulation analyzer for small to midsize clinical chemistry laboratories. We performed a laboratory evaluation. MATERIALS AND METHODS:After a familiarization period the dead volume, carry-over, capacity, within-assay reproducibi...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2013.02.004
更新日期:2013-04-01 00:00:00
abstract::Heparin cofactor II (HCII) is a specific thrombin inhibitor; its inhibitory activity is stimulated by heparin (Hep) and dermatan sulfate (DS). Vitronectin (VN), a heparin binding adhesive glycoprotein present in plasma and extracellular matrix, has been shown to decrease the stimulatory effect of Hep but not of DS on ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(92)90310-7
更新日期:1992-06-01 00:00:00
abstract:INTRODUCTION:Apoptotic cell death is a highly regulated genetic program, which has been observed in mature megakaryocytes fragmenting into platelets. The clock gene Per2, a key component of core clock oscillator, was involved in affecting both cell cycle control and apoptosis. Thus, loss of Per2 function may be conside...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2010.11.025
更新日期:2011-02-01 00:00:00
abstract::Porcine and human umbilical vein and adult blood vessels were studied for the presence and synthesis of factor VIII related antigen (VIIIR:Ag) and fibronectin (Fn) by immunofluorescence histology and immunoautoradiography. Investigation of human tissue confirmed the widespread distribution of VIIIR:Ag on the endotheli...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(83)90042-7
更新日期:1983-02-01 00:00:00
abstract::The antithrombotic actions of selective factor Xa (FXa) inhibitors, recombinant tick anticoagulant peptide (rTAP) and DX-9065a, were evaluated in experimental thrombosis models in anesthetized rats. In the first model, thrombosis was induced by exposing flowing blood to a silk thread anchored in an arteriovenous (AV) ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(96)00112-0
更新日期:1996-07-15 00:00:00
abstract::Plasma homocysteine levels result from the effect of genetic and environmental factors. We investigated the hypothesis of familial association between folates, methylenetetrahydrofolate reductase (MTHFR) and hyperhomocysteinemia with acute events, studying three families through pedigree analysis and log-linear graphi...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(01)00408-x
更新日期:2002-01-15 00:00:00
abstract:INTRODUCTION:Congenital factor V (FV) deficiency is a rare inherited disorder. Three compound heterozygous missense mutations, Asp68His, His147Arg, and Arg2074Cys, were observed in a Taiwanese patient with moderately severe FV deficiency. METHOD:The novel His147Arg mutation in the A1 domain was investigated by protein...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2014.04.005
更新日期:2014-07-01 00:00:00
abstract::The coumarin derivative AD6 is known to inhibit platelet aggregation and release and it possesses vasodilatory properties on coronary arteries of laboratory animals. Furthermore, the inhibition of the production of TxB2 from endogenous substrates after stimulation of human platelets with collagen has been demonstrated...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(87)90236-2
更新日期:1987-07-01 00:00:00
abstract::Treatment of deep venous thrombosis with low molecular weight heparin (LMWH-Novo, Logiparin) was carried out with two different doses of Logiparin, 75 XaI U/kg b.w. twice daily and 150 XaI U/kg b.w. once daily subcutaneously for 5 days. Simultaneously warfarin was given from the first day of heparin treatment. Mean ag...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/0049-3848(89)90307-1
更新日期:1989-09-15 00:00:00
abstract::Beta-thromboglobulin (beta-TG) is a platelet-specific protein present in the alpha-granules and secreted into the surrounding medium on cell activation. The sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of platelet releasate after inhibition of metalloproteinases with ethyleneglycol-bis-(beta-a...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(02)00135-4
更新日期:2002-05-15 00:00:00
abstract::Postoperative chylothorax is a frequently encountered pathology occurring in up to 4% of patients undergoing surgery for repair of congenital heart disease. Symptomatic thrombosis is associated with chylothorax and may contribute to its severity and duration. Furthermore, vessel thrombosis resulting in persistent vess...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2013.06.014
更新日期:2013-08-01 00:00:00
abstract::Two monoclonal antibodies against plasminogen and two against alpha-2-antiplasmin were characterized regarding their binding properties towards their respective native and modified antigens and towards the plasmin-alpha-2-antiplasmin complex. Using an ELISA system, the two monoclonal antibodies against plasminogen (MP...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(87)90311-2
更新日期:1987-03-01 00:00:00
abstract::The ability of the COA-SET Fibrin monomer (COA-SET FM) test to detect soluble fibrin was evaluated by comparing the results of the COA-SET FM test with fibrinopeptide A (FPA) determinations following thrombin incubation of plasma or whole blood. In addition, two semiquantitative tests (erythrocytes-agglutination test ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90066-l
更新日期:1990-02-15 00:00:00
abstract:INTRODUCTION:This study aimed to determine the risk factors for subclinical umbilical catheter-related thrombosis (UCRT) and its association with clinical morbidities. MATERIALS AND METHODS:In infants without any symptoms associated with umbilical catheterization, the presence of thrombosis was monitored using abdomin...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2020.05.034
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:This study examines whether patient resistance to clopidogrel is associated with long-term thrombotic events after elective coronary drug-eluting stent (DES) implantation. METHODS:We prospectively enrolled 386 patients with stable angina who received elective percutaneous coronary intervention (PCI) with DE...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2008.10.007
更新日期:2009-05-01 00:00:00
abstract::Defibrotide (D) is a natural polydeoxyribonucleotide from mammalian lungs with profibrinolytic and antithrombotic activities. D also has PGI2-stimulating and tissue plasminogen activator (TPA)-releasing activities, but has no anticoagulant properties. The protective effects of D were demonstrated very recently in a mo...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(86)90265-3
更新日期:1986-05-01 00:00:00
abstract::Chronic thromboembolic pulmonary hypertension (CTEPH) is the most severe long term complication of acute pulmonary embolism (PE). Untreated, CTEPH is associated with a very poor prognosis and high risk of mortality, although curation can be achieved by surgical removal of the obstructive endothelialised thromboemboli ...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2016.12.026
更新日期:2017-03-01 00:00:00
abstract::It has been suggested that unstable angina at rest, like acute myocardial infarction, might be associated with a thrombotic process. In order to study the hypothesis that myocardial ischemia during exercise could also be associated with an activation of blood coagulation and/or fibrinolysis, we investigated the presen...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(92)90222-v
更新日期:1992-01-01 00:00:00