Syndromes of Thrombosis and Hypercoagulability: Congenital and Acquired Thrombophilias

Bick, Rodger L.; Kaplan, Harold S.

doi:10.1177/107602969800400106

Cited by 59 publications

(81 citation statements)

References 235 publications

(242 reference statements)

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“…Within the general population, deep vein thrombosis (DVT) occurs with an annual frequency of 160 cases per 100,000 people, which can be extrapolated to approximately 450,000 cases annually in the United States [2]. In addition, fatal pulmonary embolism (PE) accounts for approximately 50,000-100,000 deaths per year [2].…”

Section: Introductionmentioning

confidence: 99%

Venous thromboembolism prophylaxis in medically ill patients and the development of strategies to improve prophylaxis rates

et al. 2005

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Venous thromboembolism (VTE) is common but often unrecognized in medically ill patients. Over the past 5 years, three large-scale placebo-controlled trials enrolling a total of 5500 medically ill patients have highlighted the risk of VTE in this group. These trials have helped to define a specific at-risk patient profile, including those admitted to the hospital with severe congestive heart failure, respiratory illness, acute infection, and inflammatory bowel disease. We performed a retrospective review of patients admitted to the medical service at our tertiary care center to define how common the at-risk medical patient is and to evaluate and improve prophylaxis rates in this patient group. The study was conducted in two phases. Based on admission characteristics, patients were stratified into high-risk or low-risk groups for the development of VTE. During the pre-intervention phase, 75% of patients admitted to the medical service were characterized as increased risk for VTE, yet only 43% of these high-risk patients received prophylaxis of any sort. After interventions designed to increase awareness of VTE, we conducted a second review period. In this post-intervention phase, where 79% of patients were at risk for VTE, prophylaxis rates improved to 72%. Based on these results, we conclude that the majority of patients admitted to the medical service at our tertiary care center constitute a high-risk population that warrants consideration for VTE prophylaxis. Implementation of strategies to improve prophylaxis rates, including educational sessions and risk stratification guidelines, can be successful and improve identification and prophylaxis of this population. Am.

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Section: Introductionmentioning

confidence: 99%

Venous thromboembolism prophylaxis in medically ill patients and the development of strategies to improve prophylaxis rates

et al. 2005

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“…It had been reported that congenital, heterozygous deficiency in AT increases the risk of venous thrombosis about 5-to 10-fold (26,43,44). Interestingly, patient 7 (whose IgG significantly interferes with AT inactivation of FIXa in Fig.…”

Section: Discussionmentioning

confidence: 83%

Novel Autoantibodies against the Activated Coagulation Factor IX (FIXa) in the Antiphospholipid Syndrome That Interpose the FIXa Regulation by Antithrombin

Yang

Chien

et al. 2009

The Journal of Immunology

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We previously reported that some human antiphospholipid Abs (aPL) in patients with the antiphospholipid syndrome (APS) bind to the homologous enzymatic domains of thrombin and the activated coagulation factor X (FXa). Moreover, some of the reactive Abs are prothrombotic and interfere with inactivation of thrombin and FXa by antithrombin (AT). Considering the enzymatic domain of activated coagulation factor IX (FIXa) is homologous to those of thrombin and FXa, we hypothesized that some aPLs in APS bind to FIXa and hinder AT inactivation of FIXa. To test this hypothesis, we searched for IgG anti-FIXa Abs in APS patients. Once the concerned Abs were found, we studied the effects of the Ab on FIXa inactivation by AT. We found that 10 of 12 patient-derived monoclonal IgG aPLs bound to FIXa and that IgG anti-FIXa Abs in APS patients were significantly higher than those in normal controls (p < 0.0001). Using the mean + 3 SD of 30 normal controls as the cutoff, the IgG anti-FIXa Abs were present in 11 of 38 (28.9%) APS patients. Importantly, 4 of 10 FIXa-reactive monoclonal aPLs (including the B2 mAb generated against β2-glycoprotein I significantly hindered AT inactivation of FIXa. More importantly, IgG from two positive plasma samples were found to interfere with AT inactivation of FIXa. In conclusion, IgG anti-FIXa Ab occurred in ∼30% of APS patients and could interfere with AT inactivation of FIXa. Because FIXa is an upstream procoagulant factor, impaired AT regulation of FIXa might contribute more toward thrombosis than the dysregulation of the downstream FXa and thrombin.

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“…myocardial infarction, venous embolism. 24,25 Antithrombotic drugs (e.g. reteplase, streptokinase, urokinase) help to cleave or dissolve the clotsoccluded in the blood vessel and thereby help to restore normal blood flow.…”

Section: Resultsmentioning

confidence: 99%

Preliminary Phytochemical and Pharmacological Screenings of Plumbago indica L. and Alpinia conchigera Griff.

Ibrahim

Hossain

Shajib

et al. 2018

Dhaka Univ. J. Pharm. Sci

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Syndromes of Thrombosis and Hypercoagulability: Congenital and Acquired Thrombophilias

Cited by 59 publications

References 235 publications

Venous thromboembolism prophylaxis in medically ill patients and the development of strategies to improve prophylaxis rates

Venous thromboembolism prophylaxis in medically ill patients and the development of strategies to improve prophylaxis rates

Novel Autoantibodies against the Activated Coagulation Factor IX (FIXa) in the Antiphospholipid Syndrome That Interpose the FIXa Regulation by Antithrombin

Preliminary Phytochemical and Pharmacological Screenings of Plumbago indica L. and Alpinia conchigera Griff.

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