Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Apr 2013
Thrombelastographic characterization of coagulation/fibrinolysis in horses: role of carboxyheme and metheme states.
Carboxyheme and metheme states modulate hemostasis in humans and other species. Further, carbon monoxide and/or nitric oxide production increase in inflammatory disorders involving the gastrointestinal tract, with associated hypercoagulability or hypocoagulability. In particular, the horse suffers both thrombotic or coagulopathic complications during acute gastrointestinal disease. ⋯ These data support a carbon monoxide-dominant modulation of hemostasis in normal horses. In contrast, an increase in the severity of acute gastrointestinal disease was associated with a likely nitric oxide-mediated, metheme state-induced hypocoagulable/hyperfibrinolytic state. Additional investigation is warranted to determine the role played by carbon monoxide and nitric oxide in equine thrombotic and coagulopathic disease.
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Blood Coagul. Fibrinolysis · Apr 2013
C-reactive protein and fibrin clot strength measured by thrombelastography after coronary stenting.
Inflammation is implicated in the progression of coronary artery disease and the molecular processes of inflammation and thrombosis are closely intertwined. Elevated levels of C-reactive protein (CRP) have been associated with an elevated risk of adverse ischaemic events after coronary stenting and hypercoagulability. Heightened whole blood clot strength measured by thrombelastography (TEG) has been associated with adverse ischaemic events after stenting. ⋯ Fibrinogen concentration was not significantly different across quartiles of CRP (P = 0.97). Patients with established coronary artery disease undergoing coronary stenting who have elevated CRP after PCI exhibit heightened maximal plasma fibrin clot strength as compared with those with low CRP. Thrombotic risk associated with elevated CRP may be linked to procoagulant changes and high tensile fibrin clot strength independent of fibrinogen concentration.
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Blood Coagul. Fibrinolysis · Apr 2013
Comparative StudyComparison of diagnostic performance of the heparin-induced thrombocytopenia expert probability and the 4Ts score in screening for heparin-induced thrombocytopenia.
Heparin-induced thrombocytopenia (HIT) is a serious immunological complication of heparin administration. Diagnosis of HIT is challenging, especially in critically ill patients. The clinical scoring model for predicting HIT is helpful for guiding clinical decision. ⋯ The HEP score did not display better diagnostic performance than the 4Ts score, with receiver operating characteristic (ROC) area under curve of 0.72 and 0.79 (P=0.31), respectively. The HEP score did not show better diagnostic performance than the 4Ts score for predicting HIT in our population. A large prospective validation in different sets of patients is warranted.