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Life
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Advances in Pathophysiology and Treatment of Thrombosis
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Advances in Pathophysiology and Treatment of Thrombosis

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 3730

Special Issue Editor

Dr. Heiko Rühl

E-Mail Website
Guest Editor
Institute of Experimental Hematology and Transfusion Medicine, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
Interests: venous thromboembolism; hypercoagulability; thrombophilia; coagulation inhibitors; anticoagulants

Special Issue Information

Dear Colleagues,

Thrombosis refers to localized clot formation that obstructs the normal flow of blood in arteries, veins or in the microvasculature. Diseases in which this pathologic process occurs include myocardial infarction, ischemic stroke, and venous thromboembolism. Although these disorders are among the most common causes of morbidity and mortality worldwide, their underlying pathophysiology is not fully understood. Due to the different pathogenic changes in arterial and venous thrombosis, antithrombotic drugs target either platelets or plasma proteins involved in hemostasis. They both cause bleeding as their most major negative side effect. A better understanding of the pathophysiology of hemostasis and thrombosis is crucial for a more effective and safer treatment of thrombotic diseases. This Special Issue focuses on novel insights and recent advances in this field.

Dr. Heiko Rühl
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • thrombosis
  • antiplatelet drugs
  • anticoagulants
  • myocardial infarction
  • ischemic stroke
  • venous thromboembolism
  • pathophysiology

Published Papers (2 papers)

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Research

8 pages, 245 KiB  
Article
Retinal Infarction: A Pilot Study on the Efficacy and Safety of Intravenous Thrombolysis and Underlying Aetiologies
by Sonja Schönecker, Johannes Wischmann, Dennis C. Thunstedt, Katharina Feil, Marc J. Mackert, Siegfried Priglinger and Lars Kellert
Life 2022, 12(8), 1279; https://doi.org/10.3390/life12081279 - 22 Aug 2022
Cited by 3 | Viewed by 1535
Abstract
Background: Treatment of non-arteritic central retinal artery occlusion is still inconsistent. Therefore, the current study aimed to evaluate the efficacy of intravenous thrombolysis (IVT) and describe the prevalence of co-occurring ischemic brain lesions in patients with acute visual loss due to ischemia. Methods: [...] Read more.
Background: Treatment of non-arteritic central retinal artery occlusion is still inconsistent. Therefore, the current study aimed to evaluate the efficacy of intravenous thrombolysis (IVT) and describe the prevalence of co-occurring ischemic brain lesions in patients with acute visual loss due to ischemia. Methods: We analysed 38 consecutive patients with acute visual loss between January 2015 and June 2020. Patients presenting within 4.5 h of symptom onset without any contraindication were treated with IVT. Patients underwent neurologic and ophthalmologic examination and diagnostic workup for the underlying aetiology. Follow-up was performed after 3 and 12 months. Results: Patients treated with IVT had a significantly better functional outcome at discharge compared to patients treated conservatively. No additional ischemic brain lesions were detected (0 of 38). Three patients had extracranial carotid artery stenosis ≥50%. Atrial fibrillation was present in four patients, three of whom already received oral anticoagulation. In the remaining 31 patients no embolic source was detected. However, the number of plaques were rated mild to moderate. Within three months, one patient developed transient visual loss while another suffered a contralateral transient ischemic attack. Conclusions: IVT may represent a safe and effective treatment option in patients with isolated visual loss due to ischemia. The aetiology was atherosclerotic burden rather than embolism caused by carotid stenosis or atrial fibrillation, bringing the current diagnostic procedure and therapy into question. Randomized trials are necessary to evaluate the efficacy and safety of IV thrombolysis and clarify the aetiology of isolated visual loss due to ischemia. Full article
(This article belongs to the Special Issue Advances in Pathophysiology and Treatment of Thrombosis)
13 pages, 3229 KiB  
Article
Variation in Plasma Levels of Apixaban and Rivaroxaban in Clinical Routine Treatment of Venous Thromboembolism
by Sara Reda, Eva Rudde, Jens Müller, Nasim Shahidi Hamedani, Johannes Oldenburg, Bernd Pötzsch and Heiko Rühl
Life 2022, 12(5), 705; https://doi.org/10.3390/life12050705 - 08 May 2022
Cited by 2 | Viewed by 1805
Abstract
Direct oral anticoagulants (DOACs) apixaban and rivaroxaban are broadly used in the management of venous thromboembolism (VTE). Although not routinely required, measurement of their plasma concentration is advised for an increasing number of indications. Due to the lack of therapeutic ranges, current guidelines [...] Read more.
Direct oral anticoagulants (DOACs) apixaban and rivaroxaban are broadly used in the management of venous thromboembolism (VTE). Although not routinely required, measurement of their plasma concentration is advised for an increasing number of indications. Due to the lack of therapeutic ranges, current guidelines recommend reporting DOAC plasma levels together with expected levels from previous pivotal studies. The aim of this study was to assess DOAC level variation in a large VTE patient population. Drug concentrations determined by measurement of the anti-Xa-activity using drug-specific calibrators in citrated plasma samples from patients on rivaroxaban (n = 1471) or apixaban (n = 725) were analyzed. Observed 5th–95th percentile ranges of apixaban peak/trough levels (63–299/13–114 ng/mL for 5 mg, 37–161/7–68 ng/mL for 2.5 mg twice daily) were similar to previously reported mass-spectrometry-based reference data, and 10th–90th percentile ranges of rivaroxaban peak/trough levels (98–367/8–55 ng/mL for 20 mg, 51–211/5–27 ng/mL for 10 mg once daily) were even narrower. Age and drug levels correlated weakly (r ≤ 0.330). Drug levels measured repeatedly in subgroups of patients showed a strong correlation (r ≥ 0.773). In conclusion, anti-Xa-activity-based measurement of apixaban and rivaroxaban yields reliable results. However, the paucity of levels off-range underlines the need for evidence-based thresholds to better assist clinical decision making. Full article
(This article belongs to the Special Issue Advances in Pathophysiology and Treatment of Thrombosis)
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