Unexplained arterial thrombosis: approach to diagnosis and treatment

May, Jori E.; Moll, Stephan

doi:10.1182/hematology.2021000235

Cited by 8 publications

(5 citation statements)

References 53 publications

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“…26 Some authors reviewed that there was no evidence supporting the hypothesis of the role of natural anticoagulants in the development of AT. 1,5,20,27 On the contrary, hyperhomocysteinemia and antiphospholipid antibodies are accepted as risk factors for AT. 20,[27][28][29][30] However, there were rarely studies that attempted to support this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

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Deficiency of Natural Anticoagulants Involves in the Occurrence of Arterial Thrombosis

Nguyen,

Vu,

Nguyen

et al. 2023

Clin Med�Insights�Blood�Disord

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Background The role of natural anticoagulant deficiency in the development of arterial thrombosis (AT) is controversial. Objective Our objectives were to assess the deficiency of natural anticoagulants, including protein S (PS), protein C (PC), antithrombin III (AT III) and their involvement in the occurrence of AT. Design Retrospective cross-sectional study. Methods This study was conducted in 585 patients who were examined with PS, PC, and AT III tests. The activity of PC, PS (men, women), and ATIII under 70%, 75%, 60%, and 80% was recognized as a deficiency, respectively. Peripheral blood cell and coagulation tests were performed before starting treatment. Patients with previous AT, venous thromboembolism (VTE) or anticoagulant therapy were excluded. Results Patients without thrombosis were 222 (38%), patients with newly diagnosed VTE were 281 (48%), and patients with newly diagnosed AT were 82 (14%). The most common AT sites were in the lungs, brain, and lower extremities (31.2%, 20.8%, and 20.8%, respectively). Compared to the nonthrombosis group, the AT group had a lower PS activity (%) (82.77 ± 24.09 vs 91.31 ± 27.27), a higher fibrinogen (g/L) (4.25 ± 1.68 vs 3.74 ± 1.51), a higher D-dimer (mg/L FEU) (6.16 vs 1.95), and a higher neutrophil count (G/L) (8.57 vs 6.50) with P < .05. Compared to the VTE group, the AT group had higher hemoglobin (g/L) (135.95 ± 23.75 vs 129.02 ± 25.22) and a higher neutrophil count (G/L) (8.57 vs 7.28) ( P < .05). In the AT group, the frequencies of PC, PS, and AT III deficiency were 23.1%, 28%, and 17.1%, respectively. The AT group had a higher frequency of PS deficiency than the nonthrombosis group (28% vs 17.1%, P = .035). Patients with PS deficiency had a higher risk of AT compared to those without PS deficiency (OR = 1.888, 95% CI [1.041-3.422], P = .036). Conclusion PS deficiency may be considered a factor in increasing the risk of AT.

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Section: Discussionmentioning

confidence: 99%

“…1,2 This condition can lead to venous thromboembolism (VTE) or arterial thrombosis (AT) that causes mortality and disability. [3][4][5] AT is usually associated with vessel wall injury (e.g. atherosclerosis) and platelet-mediated thrombi.…”

Section: Introductionmentioning

confidence: 99%

Deficiency of Natural Anticoagulants Involves in the Occurrence of Arterial Thrombosis

Nguyen,

Vu,

Nguyen

et al. 2023

Clin Med�Insights�Blood�Disord

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“…Accelerated coronary atherosclerosis at a younger age than in the general population is due to the underlying presence of CVD. Unexplained arterial thrombosis and malignant arterial hypertension may also be seen in some patients with vasculitis ( 97 ).…”

Section: Multiparametric Cmr Approach For Diagnosing Cardiac Involvem...mentioning

confidence: 99%

Cardiac magnetic resonance assessment of cardiac involvement in autoimmune diseases

Gulhane,

Ordovas

2023

Front. Cardiovasc. Med.

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Cardiac magnetic resonance (CMR) is emerging as the modality of choice to assess early cardiovascular involvement in patients with autoimmune rheumatic diseases (ARDs) that often has a silent presentation and may lead to changes in management. Besides being reproducible and accurate for functional and volumetric assessment, the strength of CMR is its unique ability to perform myocardial tissue characterization that allows the identification of inflammation, edema, and fibrosis. Several CMR biomarkers may provide prognostic information on the severity and progression of cardiovascular involvement in patients with ARDs. In addition, CMR may add value in assessing treatment response and identification of cardiotoxicity related to therapy with immunomodulators that are commonly used to treat these conditions. In this review, we aim to discuss the following objectives: •Illustrate imaging findings of multi-parametric CMR approach in the diagnosis of cardiovascular involvement in various ARDs;•Review the CMR signatures for risk stratification, prognostication, and guiding treatment strategies in ARDs;•Describe the utility of routine and advanced CMR sequences in identifying cardiotoxicity related to immunomodulators and disease-modifying agents in ARDs;•Discuss the limitations of CMR, recent advances, current research gaps, and potential future developments in the field.

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“…Chemotherapeutic drugs, including platinum-based agents, vascular endothelial growth factor inhibitors, tyrosine kinase inhibitors, and taxanes, have been associated with higher rates of arterial thromboembolism [ 3 ]. The management of arterial thrombosis of uncertain etiology often requires a review of the literature and often involves the input of hematologists [ 4 ]. Here, we present a case of a 68-year-old male with a history of stage IIIA colon cancer who presented to the emergency department with symptoms of nausea, vomiting, abdominal pain, diarrhea, and fatigue and received a CT scan of the abdomen and pelvis, which incidentally revealed a mural thrombus in the aortic wall, extending from the renal arteries to the mid-abdominal aorta.…”

Section: Introductionmentioning

confidence: 99%

Incidentally Discovered Aortic Thrombosis in a Patient Undergoing Capecitabine and Oxaliplatin Chemotherapy for Colon Cancer

Burton¹,

Gualdoni²,

Acharya³

2023

Cureus

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This case report describes a 68-year-old male who presented to the emergency department (ED) with nausea, vomiting, abdominal pain, diarrhea, and fatigue after starting adjuvant combination chemotherapy with capecitabine and oxaliplatin two weeks prior. Further evaluation of this patient in the ED revealed an incidentally discovered aortic thrombosis, of which this patient did not exhibit any specific symptoms. This case, among a few others, has described the development of arterial thrombosis in patients with cancer undergoing combination chemotherapy with capecitabine and oxaliplatin.

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Unexplained arterial thrombosis: approach to diagnosis and treatment

Cited by 8 publications

References 53 publications

Deficiency of Natural Anticoagulants Involves in the Occurrence of Arterial Thrombosis

Deficiency of Natural Anticoagulants Involves in the Occurrence of Arterial Thrombosis

Cardiac magnetic resonance assessment of cardiac involvement in autoimmune diseases

Incidentally Discovered Aortic Thrombosis in a Patient Undergoing Capecitabine and Oxaliplatin Chemotherapy for Colon Cancer

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