Title: Thrombosis and Haemostasis

Title: Thrombosis and Haemostasis

ISO Abbreviated Title:

JCR Abbreviated Title:

ISSN:

Journal Country/Territory:

Language:

Publisher:

Publisher Address:

Subject Categories:

: Impact Factor

? Akl, E.A., Terrenato, I., Barba, M., Sperati, F., Muti, P. and Schunemann, H.J. (2008), Extended perioperative thromboprophylaxis in patients with cancer. Thrombosis and Haemostasis, 100 (6), 1176-1180.

Abstract: We systematically reviewed the literature to compare the relative efficacy and safety of extended versus limited duration heparin for perioperative thromboprophylaxis in patients with cancer. We followed the Cochrane Collaboration systematic review methodology and searched MEDLINE, EMBASE, ISI the Web of Science, and CENTRAL. The outcomes of interest included mortality, symptomatic deep venous thrombosis (DVT), pulmonary embolism, and bleeding. We evaluated the quality of evidence by outcome using the GRADE approach. of 3,986 identified citations, we included three randomized clinical trials using low-molecular-weight heparin (LMWH). The quality of evidence for mortality, DVT, and major bleeding was low. There was no significant difference between extended (4 weeks) and limited duration thromboprophylaxis in terms of death at three months (relative risk [RR]=0.49; 95% confidence interval [CI] 0.12-1.94), or major bleeding at four weeks (RR=2.94; 95% CI 0.12-71.85). An extended regimen was associated with a significantly lower risk of asymptomatic DVT (RR=0.21; 95% Cl 0.05-0.94). No data was available for symptomatic DVT In conclusion, there is limited and low-quality evidence that extended duration LMWH for perioperative thromboprophylaxis reduces DVT in patients with cancer undergoing major abdominal or pelvic surgery. More and better quality evidence is needed to justify extended regimens.

Keywords: Cancer, Citations, Clinical Trials, Cochrane, Collaboration, Complications, Efficacy, Embase, Grade, Heparin, Heparins, Interest, ISI, Literature, Low-Molecular-Weight, Major Abdominal-Surgery, Malignancy, Medline, Metaanalysis, Methodology, Mortality, Outcome, Outcomes, Patients, Prevention, Prolonged Thromboprophylaxis, Prophylaxis, Prophylaxis, Pulmonary Embolism, Randomized Clinical Trials, Recommendations, Relative Risk, Review, Risk, Safety, Science, Surgery, Systematic, Systematic Review, Thrombosis, Thrombosis, Venous Thromboembolism, Venous Thrombosis, Web of Science

? Sofi, F., Cesari, F., Abbate, R., Gensini, G.F., Broze, G. and Fedi, S. (2010), A meta-analysis of potential risks of low levels of protein Z for diseases related to vascular thrombosis. Thrombosis and Haemostasis, 103 (4), 749-756.

Abstract: The relationship between protein Z levels and thrombosis is controversial. We performed a systematic review and meta-analysis of the available studies to assess the association between protein Z and vascular thrombotic diseases. We conducted an electronic literature search through MEDLINE, EMBASE, Google Scholar, Web of Science, The Cochrane Library, bibliographies of retrieved articles and abstracts of congresses up to October, 2009. Studies were included if they analysed protein Z levels in patients with vascular thrombotic diseases. After the review process, 28 case-control studies (33 patient cohorts), including 4,218 patients with thrombotic diseases and 4,778 controls, were selected for analysis. The overall analysis using a random-effects model showed that low protein Z levels were associated with an increased risk of thrombosis (odds ratio [OR] 2.90, 95% confidence interval [CI] 2.05-4.12; p<0.00001). On subgroup analysis, a significant association was found between low protein Z levels and arterial vascular diseases (OR 2.67, 95%CI 1.60-4.48; p=0.0002), pregnancy complications (OR 4.17, 95%CI 2.31-7.52; p<0.00001), and venous thromboembolic diseases (OR 2.18, 95%CI 1.19-4.00; p=0.01). The results of this meta-analysis are consistent with a role for protein Z deficiency in thrombotic diseases, including arterial thrombosis, pregnancy complications and venous thromboembolism.

Keywords: Analysis, Atherosclerosis, Case-Control, Case-Control Studies, Coagulation, Cochrane, G79a Polymorphism, Google Scholar, Inhibitor, Ischemic-Stroke, Literature, Meta Analysis, Meta-Analysis, Model, Patients, Pregnancy, Pregnancy Complications, Protein Z, Prothrombotic Phenotype, Ratio, Review, Risk, Science, Systematic, Systematic Review, Thromboembolism, Thrombosis, Venous Thrombosis, Web of Science, Z Deficiency, Z Gene, Z Plasma-Levels

Title: Thrombosis Research

ISO Abbreviated Title:

JCR Abbreviated Title:

ISSN: 0049-3848

Issues/Year:

Journal Country/Territory:

Language:

Publisher:

Publisher Address:

Subject Categories:

: Impact Factor

Dores, G.M., Miller, M.E. and Thorpe, S.L. (1993), Platelet adhesion at low shear rate: Study of a normal population. Thrombosis Research, 69 (2), 173-184.

Full Text: T\Thr Res69, 173.pdf

Abstract: The use of oral contraceptives (OCs) has been associated with vascular complications. The mechanism(s) by which OCs predispose to thrombotic events remains unclear. Recent studies have demonstrated that postmenopausal (PM) women who take estrogen replacement therapy (ERT) have a decreased incidence of myocardial infarction compared to those who do not take ERT. This study was undertaken to determine if healthy individuals have differences in platelet adhesion depending on hormonal status. Men, PM women taking ERT, PM women not taking ERT, OC users, and premenopausal women not taking any medications were studied. Platelet studies were performed in a Hele-Shaw flow chamber at a low shear rate using platelet-rich plasma. The platelet adhesion process to subendothelial components: fibronectin, collagen I and collagen III was recorded using a 35 mm camera mounted on an inverted microscope. Photographs were taken at 30 second intervals for a total of 12 minutes and analyzed using a modified computer program which provided a numerical account of platelet adhesion. OC users had significantly higher platelet adherence to fibronectin, collagen I and collagen III compared to all other groups. All other study groups had similar platelet adhesion independent of hormonal status. These findings suggest that OCs cause increased platelet adhesion in some individuals and this may be one of the mechanisms by which OCs contribute to thrombotic events.

Keywords: Platelet Adhesion, Estrogen Replacement Therapy, Oral Contraceptives Corresponding Author, Dose Oral-Contraceptives, Vascular Subendothelium, Cardiovascular-Disease, Venous Thromboembolism, Human-Blood, Coagulation, Collagen, Surface

? Pai, M., Evans, N.S., Shah, S.J., Green, D., Cook, D. and Crowther, M.A. (2011), Statins in the prevention of venous thromboembolism: A meta-analysis of observational studies. Thrombosis Research, 128 (5), 422-430.

Full Text: 2011\Thr Res128, 422.pdf

Abstract: Introduction: Studies have established a relationship between inflammation and venous thromboembolism (VTE). Though statins modulate inflammation, it is uncertain if they prevent VTE in heterogeneous populations. A recent randomized trial demonstrated that statins prevent VTE in healthy older adults, yet this has not been well established in other groups, including younger individuals and individuals with comorbidities. The objective of this meta-analysis was to estimate the effect of statins on VTE in a heterogeneous group of adults. Methods: We systematically reviewed the effect of statins in preventing VTE in adult inpatients and outpatients. We systematically searched MEDLINE (1966-Jan 2010), EMBASE (1980-Jan 2010), Google Scholar, Cochrane Library, PapersFirst, ProceedingsFirst, and ISI Web of Science, manually reviewed references, and contacted experts. Observational studies that compared any dose of statin to no statin or placebo, examined inpatients or outpatients, and assessed VTE, pulmonary embolism, and/or deep vein thrombosis were included. Study selection, data abstraction and study quality evaluation (using the Newcastle-Ottawa Scale) were independently conducted in duplicate. Results: Four cohort studies and four case-control studies met criteria. Comparing statins to control, the odds ratio for VTE was 0.67 (95% confidence interval 0.53, 0.84), and for deep vein thrombosis was 0.53 (95% confidence interval 0.22, 1.29). The association was attenuated in lower-quality studies and studies enrolling older individuals. Conclusions: Further well-designed trials are needed to evaluate the risks and benefits of statins in preventing VTE in heterogenous populations of adults, identify high-risk subgroups, and analyze cost-effectiveness of statin use for this indication. (C) 2011 Elsevier Ltd. All rights reserved.

Keywords: Adult, Adults, Association, Cardiovascular Events, Case-Control, Case-Control Studies, Cochrane, Cohort, Cohort Studies, Control, Cost-Effectiveness, Deep Vein Thrombosis, Embase, Evaluation, Google Scholar, Health, Hydroxymethylglutaryl-Coa, Inflammation, Inflammation, ISI, ISI Web of Science, Medline, Meta Analysis, Meta-Analysis, Methods, Observational, Observational Studies, Older Adults, Prevention, Pulmonary Embolism, Ratio, Reductase Inhibitors, Risk, Scale, Science, Statins, Therapy, Thromboembolism, Thrombosis, Venous Thrombosis, Web of Science