Journal of thrombosis and haemostasis : JTH
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J. Thromb. Haemost. · Jul 2012
Platelet- and erythrocyte-derived microparticles trigger thrombin generation via factor XIIa.
The procoagulant properties of microparticles (MPs) are due to the of the presence of phosphatidylserine (PS) and tissue factor (TF) on their surface. The latter has been demonstrated especially on MPs derived from monocytes. ⋯ MPs from platelets and erythrocytes not only propagate coagulation by exposing PS but also initiate thrombin generation independently of TF in a FXII-dependent manner. In contrast, monocyte-derived MPs trigger coagulation predominantly via TF.
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J. Thromb. Haemost. · Jul 2012
Review Meta AnalysisPrognostic clinical prediction rules to identify a low-risk pulmonary embolism: a systematic review and meta-analysis.
Prognostic assessment is important for the management of patients with a pulmonary embolism (PE). A number of clinical prediction rules (CPRs) have been proposed for stratifying PE mortality risk. The aim of this systematic review was to assess the performance of prognostic CPRs in identifying a low-risk PE. ⋯ Prognostic CPRs efficiently identify PE patients at a low risk of mortality. Before implementing prognostic CPRs in the routine care of PE patients, well-designed management studies are warranted.
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J. Thromb. Haemost. · Jul 2012
Performance of age-adjusted D-dimer cut-off to rule out pulmonary embolism.
Age-adjusted D-dimer cut-off has recently been proposed to increase D-dimer usefulness in older patients suspected of pulmonary embolism (PE). ⋯ Our study shows that age-adjusted D-dimer had low nLR, allowing its use as a rule-out PE strategy in non-high pretest clinical probability patients, as well as using Vidas(®), Liatest(®) or MDA(®) assays. This age-adjusted cut-off increased clinical usefulness of D-dimer in older patients. A large prospective study is required to confirm these results.
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J. Thromb. Haemost. · Jul 2012
Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes.
Low fibrinogen levels are known to occur in trauma. However, the extent of fibrinogen depletion during trauma hemorrhage, the response to replacement therapy and association with patient outcomes remain unclear. ⋯ Fibrinogen level is decreased in injured patients on admission and is associated with poor outcomes. ROTEM is a rapid means of assessing hypofibrinogenemia. Earlier administration of specific fibrinogen replacement may improve outcomes, and prospective controlled trials are urgently needed.