European journal of clinical investigation
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Eur. J. Clin. Invest. · Jan 2025
Altered fibrin clot properties and elevated von Willebrand factor are associated with progression to permanent atrial fibrillation: A cohort study.
The role of a prothrombotic state in atrial fibrillation (AF) progression to permanent arrythmia (PerAF) is unclear. Formation of denser and poorly lysable fibrin clots has been observed in AF patients also with sinus rhythm in association with higher stroke risk. We investigated whether altered fibrin clot properties and other prothrombotic state markers may contribute to AF transition to PerAF. ⋯ Suppressed fibrin clot susceptibility to lysis and elevated vWF could contribute to progression to PerAF despite anticoagulation, which suggests links between blood coagulation and AF progression.
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Eur. J. Clin. Invest. · Jan 2025
Meteorin-like protein plasma levels are associated with worse outcomes in de novo heart failure.
Meteorin-like protein (Metrnl) has been recently suggested as a new adipokine with protective cardiovascular effects. Its circulating levels in patients seem to be associated with heart failure (HF), although with contradictory results. Our aim was to ascertain whether this adipokine could estimate the prognosis of HF in de novo HF (DNHF) patients. ⋯ Patients with higher Metrnl levels have a worse prognosis in DNHF. Our results reinforce the association of Metrnl plasma levels with HF progression and outcomes.
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Sotatercept binds free activins by mimicking the extracellular domain of the activin receptor type IIA (ACTRIIA). Additional ligands are BMP/TGF-beta, GDF8, GDF11 and BMP10. The binding with activins leads to the inhibition of the signalling pathway and the deactivation of the bone morphogenic protein (BMP) receptor type 2. ⋯ Its effects, demonstrated in the STELLAR study, are the improvement of exercise capacity and the FC-WHO functional class, together with the reduction of the risk of clinical worsening events. In addition to its antiremodeling effects on the pulmonary circulation, sotatercept has several haematological effects that could suggest its use in the treatment of some blood disorders other than PAH. In this review, we will discuss the effects of the drug on PAH and in parallel provide an in-depth overview of its application in haematological disorders, focusing on clinical and preclinical studies.
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Eur. J. Clin. Invest. · Jan 2025
Care pathway for patients hospitalized with venous thromboembolism.
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a potentially fatal disease with a multifactorial nature, impacting different medical and surgical specialties. Recently, new guidelines and direct oral anticoagulants facilitated early discharge for most DVT patients and non-severe PE patients. ⋯ This study is the first to portray the distribution and care pathways of VTE patients across hospital departments. Despite recent clinical guidelines, many patients still require inpatient management, highlighting the need for dedicated care pathway.