Review
Hematology
Emanuele Valeriani, Francesco Paciullo, Angelo Porfidia, Pasquale Pignatelli, Matteo Candeloro, Marcello Di Nisio, Marco Paolo Donadini, Claudio Maria Mastroianni, Roberto Pola, Paolo Gresele, Walter Ageno
Summary: Based on the analysis of multiple studies, anticoagulant therapy was found to have better efficacy in terms of visual acuity improvement and recurrent RVO events compared to antiplatelet therapy, but it also carried a certain risk of bleeding complications.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Review
Cardiac & Cardiovascular Systems
Bo Chen, Nie Hu
Summary: The study indicates that LMWH is more effective than aspirin for patients with DVT after orthopaedic surgery, with no significant difference in postoperative bleeding risk between the two groups.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Review
Immunology
Hui Xia, Ziyao Wang, Min Tian, Zunjing Liu, Zhenhua Zhou
Summary: This study evaluates the difference between low-molecular-weight heparin (LMWH) and aspirin in preventing early neurological deterioration (END) and recurrent ischemic stroke (RIS), as well as their impact on post-recovery independence and safety outcomes in acute ischemic stroke patients. The results show that LMWH treatment is more effective in reducing the incidence of END and RIS, and improving independence at 6 months compared to aspirin treatment, particularly in patients with large-artery stenosis. However, LMWH is associated with an increased likelihood of extracranial hemorrhage.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Li Zheng, Binbin Xia, Yuan Yuan, Yuran Wang, Yan Wang
Summary: This systematic review examines the efficacy and safety of combining low-molecular-weight heparin (LMWH) or unfractionated heparin with low-dose aspirin (LDA) in preventing preeclampsia in high-risk women. The meta-analysis of 14 randomized controlled trials found that the addition of LMWH to LDA reduces the risk of preeclampsia, small-for-gestational age, fetal and neonatal death, and gestational hypertension without increasing the risk of bleeding. However, larger studies are needed to further validate these findings.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Obstetrics & Gynecology
Monica Cruz-Lemini, Juan Carlos Vazquez, Johana Ullmo, Elisa Llurba
Summary: A meta-analysis found that the use of low-molecular-weight heparin in high-risk women can significantly reduce the risk of preeclampsia and other placenta-related complications. If treatment is started before 16 weeks' gestation, the risk reduction is more significant. Combined treatment with low-dose aspirin can significantly reduce the risk of preeclampsia compared to using low-dose aspirin alone. Well-designed large clinical trials are needed to confirm these results.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Review
Medicine, General & Internal
Chunfeng Wu, Liling Li, Jiarong Zhang, Yang Song
Summary: The synthesis analysis indicated that the combination of low-dose aspirin and LMWH in the treatment of PE can significantly improve blood pressure, 24-hour proteinuria, and coagulation function, and may reduce adverse reactions in pregnant women without increasing adverse perinatal outcomes. No publication bias was detected in all synthesized outcomes.
ARCHIVES OF MEDICAL SCIENCE
(2022)
Review
Surgery
Alexandre Tran, Shannon M. Fernando, Rebecca S. Gates, Jacob R. Gillen, Molly E. Droege, Marc Carrier, Kenji Inaba, Elliott R. Haut, Bryan Cotton, Amanda Teichman, Paul T. Engels, Rakesh V. Patel, Jacinthe Lampron, Bram Rochwerg
Summary: This study compared anti-Xa-guided dosing with fixed dosing of low molecular weight heparin (LMWH) for VTE prevention in adult trauma patients. The findings suggest that anti-Xa-guided dosing may reduce the risk of deep vein thrombosis, pulmonary embolism, and any VTE, although the certainty of evidence is low. The impact on mortality and bleeding events remains uncertain. Overall rating: 8 out of 10.
Review
Hematology
Emanuele Valeriani, Marcello Di Nisio, Enrica Porceddu, Fabiana Agostini, Roberto Pola, Silvia Spoto, Marco Paolo Donadini, Walter Ageno, Angelo Porfidia
Summary: This meta-analysis evaluated the efficacy and safety of anticoagulant therapy for upper extremity deep vein thrombosis (UEDVT). The results showed that anticoagulant treatment is associated with a low risk of recurrent VTE and major bleeding in patients with UEDVT.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Medicine, General & Internal
Yun Sun, Linlin Cui, Yao Lu, Jichun Tan, Xi Dong, Tianxiang Ni, Junhao Yan, Yichun Guan, Guimin Hao, Jia-Yin Liu, Bo Zhang, Daimin Wei, Yan Hong, Yaqiong He, Jia Qi, Bing Xu, Juanjuan Lu, Qian Zhang, Shanshan Zhao, Xiaowei Ji, Xiaofang Du, Jie Zhang, Jinyong Liu, Jing Wang, Yingqin Huang, Dongmei Huang, Yanzhi Du, Hugo Vankelecom, Heping Zhang, Zi-jiang Chen
Summary: Prednisone treatment does not improve live birth rate in patients with recurrent implantation failure compared to placebo. The use of prednisone may increase the risk of preterm delivery and biochemical pregnancy loss. These findings challenge the value of prednisone use in clinical practice for the treatment of recurrent implantation failure.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Review
Ophthalmology
Elisa E. Cornish, Sophia L. Zagora, Kimberley Spooner, Samantha Fraser-Bell
Summary: This review assesses the effectiveness of interventions improving vision and treating macular oedema in central retinal vein occlusion and branch retinal vein occlusion. The results suggest that intravitreal anti-vascular endothelial derived growth factor treatment is recommended as first line treatment due to its high effectiveness and low rate of ocular adverse events.
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
(2023)
Letter
Oncology
Corinne Frere, Dominique Farge, Deborah Schrag, Pedro H. Prata, Jean M. Connors
Summary: International clinical practice guidelines are increasingly endorsing direct oral anticoagulants (DOACs) as a viable alternative to low-molecular-weight heparins (LMWHs) for the treatment of cancer-associated thrombosis (CAT). A recent meta-analysis of randomized controlled trials (RCTs) found that DOACs significantly reduced the risk of CAT recurrence, with no increase in all-cause mortality rates, but did pose a slight risk of bleeding.
JOURNAL OF HEMATOLOGY & ONCOLOGY
(2022)
Review
Medicine, General & Internal
Cristina Patoni, Stefania Bunduc, Levente Frim, Daniel Sandor Veres, Fanni Dembrovszky, Anna Julia Elias, Daniel Palinkas, Peter Hegyi, Balint Mihaly Eross, Peter Jeno Hegyi
Summary: LMWH therapy reduces major complication rates in moderate and severe AP. Across all identified RCTs, LMWH were initiated early after AP diagnosis and improved its prognosis.
FRONTIERS IN MEDICINE
(2023)
Article
Medicine, General & Internal
Ting Shi, Zhong-Deng Gu, Qi-zhi Diao
Summary: This study suggests that aspirin combined with low-molecular-weight heparin may improve live birth rate in pregnant women with antiphospholipid syndrome. Additionally, plasma d-dimer concentration can predict live birth rate and guide the use of anticoagulants in APS pregnant women.
Review
Endocrinology & Metabolism
Na Su, Ting Xu, Xiaodan Li, Hanrui Zheng, Bin Wu, Shengzhao Zhang, Yiling Zhou, Liang Du, Yinglan Zhao
Summary: This study evaluated the efficacy and safety of heparin and heparin related substances for the treatment of diabetic foot ulcers. The results showed that low molecular weight heparin (LMWH) did not have significant benefits in ulcer healing, while hyaluronic acid may improve ulcer healing and shorten the healing time. Both hyaluronic acid and LMWH were well tolerated for treating diabetic foot ulcers.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Review
Hematology
Allen Li, Ming Chan Zhang, Pei Li, Ali Eshaghpour, Katherine Li, Marc Carrier, Philip Wells, Mark Andrew Crowther
Summary: This study compared the efficacy and safety of direct oral anticoagulants (DOACs) with low-molecular-weight heparins (LMWHs), vitamin-k antagonists (VKAs), or no anticoagulation in patients with splanchnic vein thrombosis (SVT). The results showed that DOACs were more effective than VKAs in non-cirrhotic patients and had a reduced risk of major bleeding compared to observation, LMWHs, and VKAs. However, no difference in major bleeding was found between DOACs and other treatment options in cirrhotic patients.
THROMBOSIS RESEARCH
(2023)
Article
Cardiac & Cardiovascular Systems
Walter Ageno, Ivan B. Casella, Kok Han Chee, Sebastian Schellong, Sam Schulman, Daniel E. Singer, Marc Desch, Wenbo Tang, Isabelle Voccia, Kristina Zint, Samuel Z. Goldhaber
Summary: In this study, a higher percentage of elderly patients and those with renal impairment were found compared to randomized clinical trials for acute VTE. The use of NOACs decreased with worsening renal impairment, while not significantly associated with older age.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Article
Cardiac & Cardiovascular Systems
Lucia M. Caiano, Simona Costanzo, Teresa Panzera, Augusto Di Castelnuovo, Giovanni de Gaetano, Maria B. Donati, Walter Ageno, Licia Iacoviello
Summary: Three different measures of obesity, including BMI, waist circumference, and RFM, similarly predict the first occurrence of unprovoked VTE.
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
(2021)
Article
Clinical Neurology
Emanuele Rezoagli, Aldo Bonaventura, Jonathan M. Coutinho, Alessandra Vecchie, Vera Gessi, Roberta Re, Alessandro Squizzato, Fulvio Pomero, Matteo Bonzini, Walter Ageno, Francesco Dentali
Summary: In this large epidemiological study, the incidence of CVT was found to be comparable to population-based studies after 2000. The incidence of CVT increased among women over time. In-hospital CFR was low but higher in patients with concomitant ICH, with age, ICH, and a high number of comorbidities being independent predictors of in-hospital mortality.
Article
Hematology
Omri Cohen, Walter Ageno, Alfredo E. Farjat, Alexander G. G. Turpie, Jeffrey Weitz, Sylvia Haas, Shinya Goto, Samuel Z. Goldhaber, Pantep Angchaisuksiri, Harry Gibbs, Peter MacCallum, Gloria Kayani, Sebastian Schellong, Henri Bounameaux, Lorenzo G. Mantovani, Paolo Prandoni, Ajay K. Kakkar
Summary: Patients with inferior vena cava (IVC) thrombosis were younger and more likely to have active or previous cancer compared to those with lower extremity deep vein thrombosis (LEDVT). IVC thrombosis patients were more commonly treated with parenteral anticoagulants, while LEDVT patients more frequently received vitamin K antagonists or direct oral anticoagulants. The all-cause mortality rate was higher in IVC thrombosis patients, partly due to malignancy, with comparable rates of cancer-associated mortality and VTE recurrence between the two groups.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Cardiac & Cardiovascular Systems
Alex C. Spyropoulos, Gary E. Raskob, Alexander T. Cohen, Walter Ageno, Jeffrey Weitz, Theodore E. Spiro, Wentao Lu, Concetta Lipardi, Gregory W. Albers, C. Gregory Elliott, Jonathan L. Halperin, William R. Hiatt, Gregory Maynard, P. Gabriel Steg, Chiara Sugarmann, Elliot S. Barnathan
Summary: The study found that major bleeding in medically ill patients receiving extended thromboprophylaxis was associated with an increased risk of all-cause mortality, while nonmajor clinically relevant bleeding did not consistently lead to an increased risk of death.
Review
Pharmacology & Pharmacy
Maria Giulia Mosconi, Maurizio Paciaroni, Walter Ageno
Summary: This article discusses the development of new drugs for the treatment and prevention of stroke. Researchers have found that tenecteplase is a more effective and safer fibrinolytic agent compared to the currently approved alteplase. Additionally, the use of mannitol or hypertonic saline is recommended for patients with space-occupying hemispheric infarction. Future research should focus on improving the safety and efficacy of treatment and further evaluating promising drugs.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2022)
Article
Hematology
Walter Ageno, Jan Beyer Westendorf, Laura Contino, Eugenio Bucherini, Maria Teresa Sartori, Marco Senzolo, Elvira Grandone, Rita Santoro, Marc Carrier, Aurelien Delluc, Valerio De Stefano, Fulvio Pomero, Marco Paolo Donadini, Alberto Tosetto, Cecilia Becattini, Ida Martinelli, Barbara Nardo, Laurent Bertoletti, Marcello Di Nisio, Alejandro Lazo-Langner, Alessandro Schenone, Nicoletta Riva
Summary: This study evaluated the safety and efficacy of rivaroxaban as a potential alternative to standard anticoagulation for the treatment of splanchnic vein thrombosis (SVT) in non-cirrhotic patients. The results showed that rivaroxaban appeared to be a promising option for the treatment of SVT in this patient population.
Article
Hematology
Matteo Candeloro, Emanuele Valeriani, Manuel Monreal, Walter Ageno, Nicoletta Riva, Raquel Lopez-Reyes, Maria Luisa Peris, Jan Beyer Westendorf, Sam Schulman, Vladimir Rosa, Juan Jose Lopez-Nunez, Juan-Carlos Garcia-Pagan, Marta Magaz, Marco Senzolo, Andrea De Gottardi, Marcello Di Nisio
Summary: This study conducted an individual-patient meta-analysis to evaluate the effectiveness and safety of anticoagulation for splanchnic vein thrombosis (SVT). The results showed that anticoagulant treatment is associated with a reduced risk of recurrent VTE and major bleeding in SVT patients.
Article
Hematology
Gualtiero Palareti, Daniela Poli, Walter Ageno, Cristina Legnani, Emilia Antonucci, Eugenio Bucherini, Sophie Testa, Oriana Paoletti, Antonio Chistolini, Alessandra Serrao, Ida Martinelli, Paolo Bucciarelli, Anna Falanga, Alberto Tosetto, Luca Sarti, Daniela Mastroiacovo, Benilde Cosmi, Adriana Visona, Rita Carlotta Santoro, Nello Zanatta, Elvira Grandone, Lorenza Bertu, Vittorio Pengo, Lucia Caiano, Paolo Prandoni
Summary: This study evaluated the value of serial D-dimer testing and reduced-dose apixaban treatment in patients with unprovoked VTE. The results showed that using D-dimer testing as a basis for extending anticoagulation treatment is not accurate, and reduced-dose apixaban demonstrated high efficacy and safety in preventing recurrences.
Review
Pharmacology & Pharmacy
D. Santagata, G. Camma, M. P. Donadini, A. Squizzato, W. Ageno
Summary: The article discusses the importance of VTE prevention in acutely ill medical patients and summarizes the evidence on approved treatments and other drugs. It touches upon the pharmacological properties, clinical efficacy and safety, and current licensing approved by FDA and EMA. Expert opinion also suggests the potential role of factor XI inhibitors in VTE prevention in this setting.
EXPERT OPINION ON PHARMACOTHERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Gary E. Raskob, Walter Ageno, Gregory Albers, C. Gregory Elliott, Jonathan Halperin, Gregory Maynard, Philippe Gabriel Steg, Jeffrey Weitz, John Albanese, Zhong Yuan, Bennett Levitan, Wentao Lu, Eun Young Suh, Theodore Spiro, Concetta Lipardi, Elliot S. Barnathan, Alex C. Spyropoulos
Summary: Extending thromboprophylaxis for medically ill patients at low risk of bleeding after hospitalization provides a positive benefit-risk balance in reducing VTE and VTE-related deaths while increasing the risk of bleeding.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Medicine, General & Internal
Walter Ageno, Lorenza Bertu, Eugenio Bucherini, Giuseppe Camporese, Francesco Dentali, Matteo Iotti, Gianfranco Lessiani, Roberto Parisi, Paolo Prandoni, Michelangelo Sartori, Adriana Visona, Elisabetta Bigagli, Gualtiero Palareti
Summary: Additional six weeks of rivaroxaban treatment in patients with isolated distal DVT can reduce the risk of recurrent venous thromboembolism.
BMJ-BRITISH MEDICAL JOURNAL
(2022)
Review
Hematology
Laura Girardi, Tzu-Fei Wang, Walter Ageno, Marc Carrier
Summary: Patients with cancer have a higher risk of developing venous thromboembolism (VTE) due to specific risk factors and thrombotic and hemostatic pathophysiological pathways. Managing cancer-associated VTE can be challenging due to increased risk of recurrent events and bleeding complications. Direct oral anticoagulants have shown effectiveness, safety, and convenience compared to low-molecular-weight heparin in managing cancer-associated VTE. However, there are still unmet needs and potential solutions, such as factor XI inhibitors, to address bleeding risk, drug interactions, and liver dysfunction.
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
(2023)
Review
Hematology
Lucia M. Caiano, Nicoletta Riva, Walter Ageno
Summary: Liver cirrhosis is often accompanied by changes in hemostasis, which contributes to the theory of rebalanced hemostasis. Splanchnic vein thrombosis (SVT) is a common complication in cirrhotic patients (17-26% of cases), with liver cirrhosis being a major risk factor for SVT (24-28% of SVT cases). This narrative review focuses on the current state of anticoagulant treatment for cirrhotic SVT, particularly the potential role of direct oral anticoagulants (DOACs) and recent guidelines in this area.
EXPERT REVIEW OF HEMATOLOGY
(2023)
Article
Hematology
Walter Ageno, Emilia Antonucci, Daniela Poli, Eugenio Bucherini, Antonio Chistolini, Vittorio Fregoni, Teresa Lerede, Roberta Pancani, Simona Pedrini, Filippo Pieralli, Pasquale Pignatelli, Attilia Maria Pizzini, Gian Marco Podda, Nicola Potere, Luca Sarti, Sophie Testa, Adriana Visona, Gualtiero Palareti
Summary: This observational cohort study compares the characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19-associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses. The study finds that the risk of recurrent thrombotic events in patients with COVID-19-associated VTE is low and similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases.
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2023)