Thrombosis research
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Thrombosis research · Nov 2014
Central emboli rather than saddle emboli predict adverse outcomes in patients with acute pulmonary embolism.
In patients with acute pulmonary embolism (PE), the prognostic implications of saddle or central emboli, as observed on computed tomography (CT), remain to be established. The aim of the present study was to assess whether the presence of saddle and central emboli could be used to predict clinical outcomes in patients with PE. ⋯ Rather than saddle emboli, central emboli could be an independent prognostic factor of adverse outcomes in patients with acute PE and provide additional prognostic value when combined with other prognostic factors.
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Thrombosis research · Nov 2014
Long-term efficacy and safety of a pasteurized, plasma-derived factor VIII concentrate (Beriate® P) in patients with haemophilia A.
Beriate(®) P was first introduced in Germany in 1990 as factor VIII (FVIII):C(®) HS Behring and subsequent product improvements yielded an albumin-free formulation with a specific activity of approximately 170 IU/mg protein. In 1992, the concentration was raised to 100 IU FVIII/mL in the reconstituted product, with a mean specific activity of 270 IU/mg protein. Pathogen safety is achieved by careful donor selection and a combination of pasteurization and chromatographic purification steps. ⋯ Beriate(®) P has an excellent efficacy and safety profile. Many patients who were initiated on Beriate(®) P at our centre remain on the treatment today.
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Thrombosis research · Nov 2014
CVD risk factors are related to plasma fibrin clot properties independent of total and or γ' fibrinogen concentration.
Cardiovascular disease (CVD) risk factors are associated with total fibrinogen concentration and/or altered clot structure. It is however, unclear whether such associations with clot structure are ascribed to fibrinogen concentration or other independent mechanisms. We aimed to determine whether CVD risk factors associated with increased total and/or γ' fibrinogen concentration, were also associated with altered fibrin clot properties and secondly whether such associations were due to the fibrinogen concentration or through independent associations. ⋯ Final clot structure may contribute to increased CVD risk in vivo through associations with other CVD risk factors independent from total or γ' fibrinogen concentration.
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Thrombosis research · Nov 2014
Patent foramen ovale increases the risk of acute ischemic stroke in patients with acute pulmonary embolism leading to right ventricular dysfunction.
Patent foramen ovale (PFO) is an established risk factor for ischemic stroke. Since acute right ventricular dysfunction (RVD) observed in patients with PE can lead to right-to-left inter-atrial shunt via PFO, we hypothesized that PFO is a risk factor for ischemic stroke in PE with significant right ventricular dysfunction. ⋯ Our data suggest that acute pulmonary embolism resulting in right ventricular dysfunction may lead to acute ischemic stroke in patients with patent foramen ovale. However, the clinical significance of such lesions remains to be determined.
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Thrombosis research · Oct 2014
Platelet activation biomarkers in Berkeley sickle cell mice and the response to prasugrel.
Vaso-occlusive crisis (VOC) is a common complication that occurs in sickle cell disease (SCD) patients. Although underlying mechanisms of VOC remain unclear, platelet activation has been associated with VOC. In the present study, plasma adenine nucleotide measurements using LC-ESI-MS/MS showed that plasma ADP in the Berkeley murine model of SCD was significantly higher (applox. 2.7-fold increase) compared with control mice. ⋯ Oral administration of prasugrel effectively inhibited ex vivo platelet activation consistent with clinical data in patients with SCD. In conclusion, in the Berkeley murine model of SCD, we found evidence of basal and agonist-stimulated platelet activation which could in part be attenuated by prasugrel. These data are consistent with observations made in patients with SCD and suggest possible utility of this murine model and prasugrel therapy in exploring treatment options for patients with SCD.