Thrombosis research
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Thrombosis research · Feb 2017
ReviewReciprocal links between venous thromboembolism, coagulation factors and ovarian cancer progression.
Ovarian cancer is the most lethal gynecological malignancy, which is due to late presentation. Treating advanced stage ovarian cancer is difficult, and tumor recurrence and chemoresistance frequently occur. In addition, early detection remains a major challenge as there are no early warning signs and no appropriate biomarkers. ⋯ This makes patients more prone to experiencing venous thromboembolism (VTE), and the occurrence of VTE in ovarian cancer patients adversely affects survival. Coagulation activation also promotes tumor progression as it influences tumor biology at several stages and the decreased survival rates associated with ovarian cancer-associated thrombosis are more likely due to cancer metastasis rather than to fatal thromboembolic events. In this review, we will discuss; (1) Population studies that address the bidirectional relationship between VTE and ovarian cancer, and the most important risk factors involved; (2) The mechanisms of coagulation factors and platelets that are critically involved in the development of VTE, and the progression of ovarian cancer; (3) Roles and future directions of coagulation factors in ovarian cancer therapy, and in diagnosis and prognosis of ovarian cancer as biomarkers.
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Thrombosis research · Feb 2017
Letter Comparative StudyComparative effectiveness and safety of direct oral anticoagulants (DOACs) versus conventional anticoagulation for the treatment of cancer-related venous thromboembolism: A retrospective analysis.
The standard of care for the treatment of cancer-related venous thromboembolism (VTE) is a low molecular weight heparin (LMWH) formulation. The recent development of direct oral anticoagulants (DOACs) and their approval for the treatment of VTE has resulted in several new options for treatment. If equivalent to LMWH in terms of safety and effectiveness, the use of DOACs in the treatment of cancer-related VTE would reduce the risk of VTE recurrence while potentially improving the quality of life of many cancer patients. ⋯ DOACs appear to be as safe and effective as conventional therapy for the treatment of cancer-related VTE. Results of ongoing randomized clinical studies may provide definitive evidence and clarify the role of the DOACs in the setting of malignancy.
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Thrombosis research · Jan 2017
Aplastic anemia and risk of deep vein thrombosis and pulmonary embolism: A nationwide cohort study.
Deep vein thrombosis (DVT) and pulmonary embolism (PE) constitute venous thromboembolism (VTE), which is not fully known in aplastic anemia (AA). Therefore, we investigated the incidence and risk of VTE in AA patients. ⋯ This nationwide cohort study indicated that AA is associated with increased incidence and risk of VTE.
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Thrombosis research · Dec 2016
LetterStability of direct oral anticoagulants in whole blood and plasma from patients in steady state treatment.
Using functional haemostasis assays, we demonstrated important differences in stability of direct oral anticoagulants (DOACs) in citrated whole blood and plasma from DOAC treated patients. Laboratories and clinicians should take this into consideration and adjust clinical practices accordingly.
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Thrombosis research · Dec 2016
Risk stratifying emergency department patients with acute pulmonary embolism: Does the simplified Pulmonary Embolism Severity Index perform as well as the original?
The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score to estimate the 30-day mortality of emergency department (ED) patients with acute pulmonary embolism (PE). A simplified version (sPESI) was derived but has not been as well studied in the U.S. We sought to validate both indices in a community hospital setting in the U.S. and compare their performance in predicting 30-day all-cause mortality and classification of cases into low-risk and higher-risk categories. ⋯ Both indices identified patients with PE who were at low risk for 30-day mortality. The sPESI, however, misclassified a significant number of low-mortality patients as higher risk, which could lead to unnecessary hospitalizations.