scholarly journals Clinical Relevance of VEGFA (rs3025039) +936 C>T Polymorphism in Primary Myelofibrosis: Susceptibility, Clinical Co-Variates, and Outcomes

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1271
Author(s):  
Laura Villani ◽  
Adriana Carolei ◽  
Vittorio Rosti ◽  
Margherita Massa ◽  
Rita Campanelli ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Plasma Cholesterol ◽  
High Sensitivity ◽  
Primary Myelofibrosis ◽  
Cholesterol Concentration ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Lower Plasma Cholesterol ◽  
Deep Vein

We evaluated the association of VEGFA rs3025039 polymorphism with clinical co-variates and outcomes in 849 subjects with primary myelofibrosis (PMF) and 250 healthy controls. Minor T-allele frequency was higher in subjects with JAK2V617F compared with those without JAK2V617F (18% vs. 13%; p = 0.014). In subjects with JAK2V617F, the TT genotype was associated at diagnosis with lower platelet concentrations (p = 0.033), higher plasma LDH concentration (p = 0.005), higher blood CD34-positive cells (p = 0.027), lower plasma cholesterol concentration (p = 0.046), and higher concentration of high-sensitivity C-reactive protein (p = 0.018). These associations were not found in subjects with PMF without JAK2V617F. In subjects with the TT genotype, risk of death was higher compared with subjects with CC/CT genotypes (HR = 2.12 [1.03, 4.35], p = 0.041). Finally, the TT genotype was associated with higher frequency of deep vein thrombosis in typical sites (12.5% vs. 2.5%; OR = 5.46 [1.51, 19.7], p = 0.009). In conclusion, in subjects with PMF, the VEGFA rs3025039 CT or TT genotypes are more common in those with JAK2V617F than in those without JAK2V67F mutation and are associated with disease severity, poor prognosis, and risk of deep vein thrombosis.

scholarly journals Soluble p-selectin, D-dimer, and high-sensitivity C-reactive protein after acute deep vein thrombosis of the lower limb

2011 ◽  
Vol 54 (6) ◽  
pp. 48S-55S ◽  
Author(s):  
Thomas Gremmel ◽  
Cihan Ay ◽  
Daniela Seidinger ◽  
Ingrid Pabinger ◽  
Simon Panzer ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
Acute Deep Vein Thrombosis ◽  
Soluble P ◽  
Deep Vein ◽  
D Dimer

D-Dimers, Thrombin Antithrombin III Complexes and Prothrombin Fragments 1 + 2: Diagnostic value in Clinically Suspected Deep Vein Thrombosis

1991 ◽  
Vol 65 (01) ◽  
pp. 028-032 ◽  
Author(s):  
B Boneu ◽  
G Bes ◽  
H Pelzer ◽  
P Sié ◽  
H Boccalon
Keyword(s):  
Deep Vein Thrombosis ◽  
Antithrombin Iii ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Vein Thrombosis ◽  
High Negative Predictive Value ◽  
Deep Vein ◽  
D Dimer ◽  
Mercury Strain Gauge

SummaryThis study was performed to determine the accuracy of D-Dimer fibrin derivatives, thrombin-antithrombin III (TAT) complexes and prothrombin fragments 1 + 2 (F 1 + 2) determinations for the diagnosis of deep vein thrombosis (DVT). One hundred and sixteen consecutive patients referred to the angiology unit of our hospital for a clinically suspected DVT were investigated. They were submitted to mercury strain gauge plethysmography and to ultrasonic duplex scanning examination; in cases of inconclusive results or of proximal DVT (n = 35), an ascending phlebography was performed. After these investigations were completed, the diagnosis of DVT was confirmed in 34 and excluded in 82. One half of the patients were already under anticoagulant therapy at the time of investigation. The 3 biological markers were assayed using commercially available ELISA techniques and the D-Dimer was also assayed with a fast latex method. The normal distribution of these markers was established in 40 healthy blood donors. The most accurate assay for the diagnosis of DVT was the D-Dimer ELISA which had both a high sensitivity (94%) and a high negative predictive value (95%). The D-Dirner latex, TAT complexes and F 1 + 2 were far less sensitive and provided negative predictive values which ranged between 78 and 85%. In spite of positive and significant correlations between the levels of ihe 3 markers, their association did not improve their overall accuracy for detecting D\/L Therefore, with the exception of the D-Dimer ELISA, these markers were of little value for the diagnosis of DVT in this specific population.

Features of Thrombi and Diagnostic Accuracy of Impedance Plethysmography in Symptomatic and Asymptomatic Deep Vein Thrombosis

1993 ◽  
Vol 70 (02) ◽  
pp. 266-269 ◽  
Author(s):  
Giancarlo Agnelli ◽  
Benilde Cosmi ◽  
Stefano Radicchia ◽  
Franca Veschi ◽  
Enrico Boschetti ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Diagnostic Accuracy ◽  
High Sensitivity ◽  
Impedance Plethysmography ◽  
Surveillance Programme ◽  
Vein Thrombosis ◽  
Asymptomatic Patients ◽  
High Prevalence ◽  
The Mean ◽  
Deep Vein

SummaryImpedance plethysmography (IPG) has high sensitivity and specificity in patients with symptomatic deep vein thrombosis (DVT) while it fails to detect asymptomatic DVT. The aim of this study was to determine whether the features of thrombi such as location, size and occlusiveness could explain the different accuracy of IPG in symptomatic and asymptomatic DVT patients. One-hundred and seventeen consecutive outpatients with a clinical suspicion of DVT and 246 consecutive patients undergoing hip surgery were admitted to the study. In symptomatic patients IPG was performed on the day of referral, followed by venography, while in asymptomatic patients IPG was performed as a surveillance programme, followed by bilateral venography.A venography proved DVT was observed in 37% of the symptomatic patients and 34% of the asymptomatic limbs. A significantly higher proportion of proximal DVTs was found in symptomatic patients than in asymptomatic patients (78% vs 46%; p = 0.001). The mean Marder score, taken as an index of thrombus size, was significantly higher in symptomatic patients than in asymptomatic patients (19.0 vs 9.6; p = 0.0001). A significantly higher proportion of occlusive DVTs was observed in symptomatic than in asymptomatic patients (69% vs 36%; p = 0.001).We conclude that the unsatisfactory diagnostic accuracy of IPG in asymptomatic DVT is due to the high prevalence of distal, small and non occlusive thrombi. Such thrombi are unlikely to cause a critical obstruction of the venous outflow and therefore to produce a positive IPG.

Application of Inferior Vena Cava Nanofilter Combined with Thrombolytic Catheter for Intravenous Thrombolysis in Deep Vein Thrombosis of Lower Extremities

2021 ◽  
Vol 11 (6) ◽  
pp. 1187-1193
Author(s):  
Hongwei Liao ◽  
Yi Wang
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Intravenous Thrombolysis ◽  
Lower Extremities ◽  
High Sensitivity ◽  
Clinical Value ◽  
Vein Thrombosis ◽  
Deep Vein

Deep vein thrombosis (DVT) of the lower extremities has a high incidence and is insidiously fatal. Detachment of the thrombus can quickly cause death. Early detection and timely treatment are key to the treatment of DVT. This study is the first to report the clinical value of an inferior vena cava nanofilter combined with thrombolytic catheter for intravenous thrombolysis in DVT. The study found that the inferior vena cava nanofilter combined with the thrombolytic catheter has a significant effect on the treatment of DVT, which greatly reduces the circumference difference of the upper and lower legs, reduces the levels of fibrinogen, high-sensitivity C-reactive protein, and D-dimer, reduces the occurrence of complications, and is safe and worthwhile promotion.

Diagnosis Of Deep Vein Thrombosis - “The Case for NonInvasive Testing”

1981 ◽  
Author(s):  
R Hull ◽  
J Hirsh
Keyword(s):  
Deep Vein Thrombosis ◽  
High Sensitivity ◽  
Cost Effective ◽  
Impedance Plethysmography ◽  
Noninvasive Testing ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Long Term Follow Up ◽  
Deep Vein ◽  
High Degree

Ascending venography, although the diagnostic standard for deep vein thrombosis (DVT), has important clinical pitfalls and shortcomings. It is invasive and thus not readily repeated: its use is associated with significant discomfort in many patients and in 3-4% of patients post-veno- graphic phlebitis is induced. A high degree of technical and interpretive skill is required and in up to 20% of patients routine ascending venography fails to visualize the external and common iliac veins. In many hospitals, outpatient access is not readily available necessitating admission to hospital for elective venography. Non-invasive testing with impedance plethysmography (IPG) is gaining increasing acceptance and use because it is objective, versatile and free of morbidity. IPG is sensitive and specific for symptomatic proximal DVT, but has the potential limitation that it is insensitive to calf DVT. Because of this, two different non-invasive approaches are currently advocated: a) serial IPG’s to detect calf vein thrombi which extend proximally (advocates of this approach suggest that calf DVT rarely lead to symptomatic pulmonary emboli unless proximal extension occurs) and b) addition of leg scanning to detect calf DVT. The effectiveness of serial IPG’s is uncertain and to resolve this issue we are currently performing a randomized trial. Multiple large studies however demonstrate that because of both high sensitivity and specificity, the combined approach of IPG and leg scanning provides a replacement for venography in the majority of symptomatic patients. Furthermore, the safety of witholding anticoagulant therapy in patients negative by combined IPG and leg scanning has been confirmed by long-term follow-up. Combined IPG and leg scanning is more cost-effective than elective venography because these non-invasive tests are readily performed in the emergency room or clinic, thus preventing unnecessary admission to hospital of patients with clinically suspected DVT who are negative by testing.

scholarly journals Analysis of Perioperative Risk Factors for Deep Vein Thrombosis in Patients With Femoral and Pelvic Fractures

2020 ◽  
Author(s):  
Linqin Wu ◽  
Bo Cheng
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Blood Transfusion ◽  
Perioperative Period ◽  
Pelvic Fractures ◽  
C Reactive Protein ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
Independent Risk Factors ◽  
Deep Vein

Abstract Objective: Clinical characteristics, anticoagulant protocols and risk factors of deep Vein thrombosis (DVT) in patients with femoral and pelvic fractures were analyzed throughout the perioperative period to provide references for early identification and optimization of risk factors.Methods: This was a retrospective study. A total of 569 patients undergoing surgery of femoral and pelvic fractures from May 2018 to December 2019 were included. The Clinical data including general conditions,trauma, surgery,anticoagulant protocols and laboratory indexes were collected.According to the results of deep vein Doppler ultrasonography of the lower extremities, the patients were divided into non-DVT group and DVT group.Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors of preoperative and postoperative DVT.Results: The incidence of DVT was 40.25%, PE was 1.93%, and preoperative DVT was 26.71%,which was higher than the incidence of postoperative DVT of 17.22%. Most of them were thrombus on the affected side (60.26%) and distal thrombus (81.66%).The average time of DVT formation was 6.55±0.47 days after trauma and 6.67±0.48 days after surgery. Chronic obstructive pulmonary disease(COPD), anemia, hypoproteinemia, non-anticoagulation before surgery, delayed anticoagulation after trauma and admission, high energy trauma, multiple injuries, drinking history, and advanced age were independent risk factors for perioperative DVT.The increased level of fibrinogen degradation products was an independent risk factor for preoperative DVT. These risk factors were identified to be independently associated with postoperative DVT, including intraoperative blood transfusion, postoperative blood transfusion, pulmonary infection, preoperative non-anticoagulation, postoperative delayed anticoagulation, preoperative waiting time > 7d, operative time > 2h, c-reactive protein, fibrinogen level, platelet count 1 day after surgery, c-reactive protein, fibrinogen, and hemoglobin levels 3 days after surgery, comminuted fracture.Conclusions: At present, anticoagulation and other DVT prevention and treatment programs have not changed the current situation that the incidence of DVT is still high. Through the analysis of the risk factors of DVT throughout the perioperative period, optimizing the perioperative blood transfusion, preoperative lung disease, hypoproteinemia, anemia, inflammation, etc., and surgery as soon as possible after trauma may further reduce its incidence.

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