Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
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Clin. Appl. Thromb. Hemost. · Feb 2010
Randomized Controlled TrialEffects of acute hypervolemic fluid infusion of hydroxyethyl starch and gelatin on hemostasis and possible mechanisms.
The purpose of this study was to investigate the effects of acute hypervolemic fluid infusion (AHFI) of 6% hydroxyethyl starch (HES) 130/0.4 or 4% succinylated gelatin (GEL) on hemostasis and the possible mechanisms. ⋯ Gelatin reduced clot quality associated with derangements of fibrin polymerization and HES 130/0.4 delayed initiation of sufficient thrombin generation to convert fibrinogen to fibrin and impaired platelet function.
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Clin. Appl. Thromb. Hemost. · Feb 2010
Early stent thrombosis in patients undergoing primary coronary stenting for acute myocardial infarction: incidence, a simple risk score, and prognosis.
One of the major concerns remaining in the treatment with stenting of patients with acute myocardial infarction (AMI) is the occurrence of stent thrombosis (ST). The aim of the current study is to investigate the incidence, predictors, and long-term outcomes of early ST after primary coronary stenting for AMI in a large population. ⋯ Early ST after primary coronary stenting in AMI is strongly related with increased long-term cardiovascular mortality. Premature clopidogrel therapy discontinuation is the most powerful predictor of early ST.
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Clin. Appl. Thromb. Hemost. · Feb 2010
Type and location of venous thromboembolism in carriers of Factor V Leiden or prothrombin G20210A mutation versus patients with no mutation.
Factor V Leiden (FVLeiden) and prothrombin G20210A are the most common genetic causes of thrombophilia and established risk factors for different clinical manifestations of venous thromboembolism (VTE). This study investigated whether the clinical manifestation of VTE, the extension of deep vein thrombosis (DVT) and the presence of transient risk factors at the time of the first VTE, differed among patients with mutations (97 with FVLeiden; 33 with prothrombin G20210A) and in 109 patients without thrombophilia. Isolated pulmonary embolism (PE) was less prevalent in patients with FVLeiden (6%) and no thrombophilia (6%) than in those with prothrombin G20210A (15%). ⋯ Thrombosis of the upper limb was more frequent in a group without thrombophilia than in patients with mutations (P < .01). Transverse sinus venous thrombosis was present only in patients with prothrombin G20210A. Carriers of prothrombin G20210A have an increased risk of developing isolated PE and more severe clinical manifestations than those with FVLeiden or without thrombophilia.
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Clin. Appl. Thromb. Hemost. · Dec 2009
Clinical TrialUse of heparin in women with early and late miscarriages with and without thrombophilia.
In women with a history of recurrent miscarriage, the risk of miscarriage in a subsequent pregnancy is about 30% to 40%. In patients with thrombophilia, the risk is even higher. Placental thrombosis has been found in women with unexplained recurrent miscarriage independent of thrombophilia. In addition, proinflammatory changes, for example, altered Th1 to Th2 cytokine ratio and complement activation, have been repeatedly demonstrated in these women. Because of the fact that heparin has both anticoagulative and anti-inflammatory effects, the current study evaluated the efficacy of low-molecular-weight heparin (LMWH) in unexplained abortions. ⋯ Our data support the notion that LMWH is efficacious in patients with recurrent abortions and thrombophilia. We demonstrated the same effect of LMWH in women with unexplained abortions without thrombophilia. The potential mechanism of action of LMWH in early and late abortions warrants further study.
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Clin. Appl. Thromb. Hemost. · Dec 2009
Case ReportsAcute massive pulmonary embolism with hemodynamic compromise treated successfully with thrombolytic therapy.
A 78 year-old woman presented with a history of 15 days of dyspnea and tachypnea at rest. A distended right ventricle with free-wall hypokinesis and displacement of the interventricular septum toward the left ventricle were shown on echocardiography. ⋯ With the diagnosis of pulmonary embolism confirmed, recombinant tissue plasminogen activator was given immediately in the catheterization room. This case shows how pulmonary embolism can be diagnosed with pulmonary angiography during cardiopulmonary resuscitation and the life-saving result from rapid thrombolysis with recombinant tissue plasminogen activator.