Prethrombotic, prothrombotic, thrombophilic states, hypercoagulable state, thrombophilia etc.: semantics should be respected even in medical papers

Girolami, Antonio; Cosi, Elisabetta; Ferrari, Silvano; Lombardi, Annamaria; Girolami, Bruno

doi:10.1007/s11239-016-1459-8

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…The prethrombotic state, also known as the hypercoagulable state, refers to a pathological state characterized by an imbalance between the anticoagulant system and the coagulation system, which makes thrombus formation possible. FIB, FDP, and D-D levels are reliable indicators of the prethrombotic state, and D-D levels are also used to reflect secondary fibrinolysis 33 . Our results also showed that the sequential application of TXA during the perioperative period can better stabilize the structure of FIB and reduce the generation of FDP and D-D.…”

Section: Discussionmentioning

confidence: 99%

The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial

Dong,

Tang,

Lei

et al. 2024

International Journal of Surgery

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Background: Tranexamic acid (TXA) has been utilized in spinal surgery to effectively reduce intraoperative blood loss (IBL) and allogeneic blood transfusion rates. However, the traditional TXA regimen might last the entire duration of hyperfibrinolysis caused by surgical trauma, resulting in its limited ability to reduce postoperative blood loss (PBL). Therefore, the aim of this study was to investigate the effectiveness of perioperative sequential administration of multiple doses of TXA in reducing PBL in patients who underwent posterior lumbar interbody fusion (PLIF). Methods: From February 2022 to June 2023, 231 patients who were diagnosed with lumbar degenerative disease and scheduled to undergo PLIF were prospectively enrolled in the present study. The patients were randomly divided into three groups. Moreover, all patients received an intravenous injection of TXA at a dose of 15 mg/kg 15 min before surgical skin incision. Patients in Group A received a placebo of normal saline after surgery, while patients in Group B received three additional intravenous injections of TXA at a dose of 15 mg/kg every 24 h. Patients in Group C received three additional intravenous injections of TXA at a dose of 15 mg/kg every 5 h. The primary outcome measure was PBL. In addition, this study assessed total blood loss (TBL), IBL, routine blood parameters, liver and kidney function, coagulation parameters, fibrinolysis indexes, inflammatory indicators, drainage tube removal time (DRT), length of hospital stay (LOS), blood transfusion rate, and incidence of complications for all subjects. Results: The PBL, TBL, DRT, and LOS of Group B and Group C were significantly lower than those of Group A (P<0.05). The level of D-dimer (D-D) in Group C was significantly lower than that in Group A on the first day after the operation (P=0.002), and that in Group B was significantly lower than that in Group A on the third day after the operation (P=0.003). The interleukin-6 levels between the three groups from 1-5 days after the operation were in the order of Group A > Group B > Group C. No serious complications were observed in any patient. The results of multiple stepwise linear regression analysis revealed that PBL was positively correlated with incision length, IBL, smoking history, history of hypertension, preoperative fibrinogen degradation product (FDP) level, and blood transfusion. It was negatively correlated with preoperative levels of fibrinogen (FIB), red blood cells (RBCs), blood urea nitrogen (BUN), and age. Compared to female patients, male patients had an increased risk of PBL. Finally, the incidence of PBL was predicted. Conclusions: Sequential application of multiple doses of TXA during the perioperative period could safely and effectively reduce PBL and TBL, shorten DRT and LOS, reduce postoperative D-D generation, and reduce the postoperative inflammatory response. In addition, this study provided a novel prediction model for PBL in patients undergoing PLIF.

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Section: Discussionmentioning

confidence: 99%

The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial

Dong,

Tang,

Lei

et al. 2024

International Journal of Surgery

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“…We also found the trend of HCT changes in the TXA group were relatively small, which is consistent with the research results of Dong W et al and Kelly M et al 45 , 46 D-D can be a reliable indicator of the pre-thrombotic state. 47 Interestingly, the average level of D-D at postoperative day 1 in TXA group is significantly lower than that in control group [2815 (1717.5–4497.5) ug/L VS 6415 (3917.5–8482.5) ug/L, P < 0.001)]. This indicates that TXA can effectively reduce postoperative D-D levels, which is supported by Dong et al 46 In addition, neither group of patients experienced any postoperative adverse events or TXA related complications.…”

Section: Disscussionmentioning

confidence: 99%

Effect of Tranexamic Acid on Hidden Blood Loss in Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Study

Li,

Ge,

Tian

et al. 2024

TCRM

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Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has become one of the most popular minimally invasive surgeries today. However, the issue of hidden blood loss (HBL) in this surgery has received little attention. This study aims to examine the HBL in PE-TLIF surgery and the effect of tranexamic acid (TXA) on blood loss. Methods: In our research, We conducted a retrospective analysis of 300 patients who underwent PE-TLIF from September 2019 to August 2023. They were divided into 2 groups based on whether they received intravenous TXA injection before surgery. The variables compared included: demographic data, pre-and postoperative hemoglobin (HB), hematocrit (HCT), platelets (PLT), red blood cells (RBC), total blood loss (TBL), visible blood loss (VBL), HBL, operation time, postoperative hospital stay, inflammatory markers, coagulation parameters, and adverse events. Results: Regarding demographic characteristics, besides the operation time, no significant differences were observed between the two groups. Compared with the control group, the TXA group showed a significant reduction trend in TBL, HBL, and VBL (P < 0.05). On the first day after surgery, there were significant differences in prothrombin (PT), activated partial thromboplastin time (APTT), and D-dimer (D-D) levels between the two groups. Similarly, HCT also found similar results on the third day after surgery. No adverse events occurred in either group. Conclusion: Research has found that there is a significant amount of HBL in patients undergoing PE-TLIF. Intravenous injection of TXA can safely and effectively reduce perioperative HBL and VBL. Additionally, compared to the control group, the TXA group shows a significant reduction in operation time.

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“…Namely, the pathological conditions favoring thrombosis caused by functional changes in vascular endothelial cells, platelets, coagulation, anticoagulation and fibrinolysis systems ( 3 ). It’s been reported that the pre-thrombotic state is highly associated with the occurrence of VTE, whereas the pre-thrombotic state is attributed to several risk factors, such as malignant tumor and fracture ( 4 , 5 ). Therefore, the early identification of patients with potential risk of pre-thrombotic state are essential to the progress of VTE.…”

Section: Introductionmentioning

confidence: 99%

Identification of molecular markers for pre-thrombotic state: validation in the rabbits with tibia fracture or lung cancer

Yan¹,

Hu²,

Chen³

et al. 2019

Transl. Cancer Res.

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Background Currently there is no reports on identifying molecular markers for pre-thrombotic state in animal experimental settings. It’s necessary to explore the potential molecular markers for pre-thrombotic state to provide evidence for the pharmacotherapy of venous thromboembolism (VTE). Methods A total of 36 male rabbits were randomly divided into Sham, Tibia fracture, Lung cancer, Tibia fracture and lung cancer group. Pro-thrombin time (PT), thrombin time (TT), activated partial pro-thrombin time (APTT), fibrinogen (FIB), D-dimer (D-D) and anti-thrombin III (AT-III) at baseline, 1, 7, 14 and 21 days after operation were detected. Immuno-histochemical staining of tumor tissue sections was performed to observe the expression of CD31, VEGF and vWF. Western blot and qPCR were used to detect the expression levels of ANG and VEGF gene in tumor tissues. Furthermore, we analyzed the tumor tissue with HE staining, immunochemistry, qPCR and Western blot. all the data were statistically analyzed with GraphPad Prism 6. Results There were 0, 1, 2, 4 cases of VTE in sham, tibia fracture, lung cancer, tibia fracture and lung cancer group respectively. The level of PT, APTT, TT and AT-III were significantly decreased after operation (all P<0.05), whereas the level of FIB and D-D were significantly increased after operation (all P<0.05). The level of PT, APTT, TT and AT-III were gradually decreased in tibia fracture, lung cancer, tibia fracture and lung cancer group respectively (all P<0.05), while the level of FIB and D-D were gradually increased in tibia fracture, lung cancer, tibia fracture and lung cancer group respectively (all P<0.05). The medullary lymphocytes increased significantly in the lung cancer group, tibia fracture and lung cancer group (all P<0.05), and the number of medullary lymphocytes in tibia fracture and lung cancer group is significantly higher than that of lung cancer group (P<0.001). The expression of CD31, VEGF and vWF in Tibia fracture and lung cancer group is significantly higher than that of lung cancer group (all P<0.001). The expression ANG and VEGF in tibia fracture and lung cancer group is significantly higher than that of lung cancer group (all P<0.01). Conclusions PT, TT, APTT, FIB, D-D and AT-III seem to be sensitive molecular markers for identifying the pre-thrombotic state. CD31, VEGF, ANG and vWF play an important role in the progression of the pre-thrombotic state.

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Prethrombotic, prothrombotic, thrombophilic states, hypercoagulable state, thrombophilia etc.: semantics should be respected even in medical papers

Cited by 7 publications

References 27 publications

The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial

The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial

Effect of Tranexamic Acid on Hidden Blood Loss in Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Study

Identification of molecular markers for pre-thrombotic state: validation in the rabbits with tibia fracture or lung cancer

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