Publications by authors named "Corinne Frere"

Article Synopsis
  • A study was conducted during the COVID-19 pandemic in France to evaluate the effectiveness of various biomarkers in predicting short-term worsening (STW) of the disease in hospitalized patients.
  • The research involved analyzing data from 511 consecutive COVID-19 patients across 20 hospitals, identifying key blood test markers that could help in severity triage.
  • The results showed that out of the patients analyzed, 11.7% experienced STW, with certain biomarker levels at admission indicating a higher risk of rapid deterioration within seven days.
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  • Severe thrombotic antiphospholipid syndrome (APS) significantly affects critical organs and has not been thoroughly studied in ICU patients, particularly regarding hematological issues.
  • A retrospective study in France tracked 134 APS patients in ICUs, revealing high rates of anemia (95%) and thrombocytopenia (93%), with low platelet counts linked to increased mortality.
  • The findings highlight the importance of understanding the causes of thrombocytopenia in APS patients, as conditions like thrombotic microangiopathy (TMA), heparin-induced thrombocytopenia (HIT), and disseminated intravascular coagulation (DIC) are prevalent in this population.
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During extracorporeal membrane oxygenation (ECMO) support, the high shear stress in the ECMO circuit results in increased proteolysis of von Willebrand factor (VWF), loss of VWF high-molecular-weight multimers, and impaired ability to bind to platelets and collagen. These structural changes in VWF are consistent with acquired von Willebrand syndrome (AVWS) type 2A and may contribute to the bleeding diathesis frequently observed in ECMO patients. We performed a systematic review of all clinical studies evaluating the prevalence and associated outcomes of AVWS in ECMO patients.

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  • Management of dual antiplatelet therapy (DAPT) in VA-ECMO patients post-acute myocardial infarction (AMI) presents challenges, with significant occurrences of severe bleeding and coagulation issues.
  • A study analyzed 176 post-AMI patients on VA-ECMO, finding nearly 39% experienced severe bleeding and a high mortality rate of 49%.
  • Factors such as female sex, duration on ECMO, and certain biomarkers were linked to an increased risk of severe bleeding, which led to the discontinuation of antiplatelet therapy in one-third of the cases.
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  • The article discusses how to manage venous thromboembolism (VTE) in patients with malignant brain tumors, which include both primary and metastatic types.
  • It notes that there is limited data since brain tumor patients are often excluded from major clinical trials comparing various anticoagulants, making research mainly reliant on small observational studies.
  • The findings suggest that direct Factor Xa inhibitors might lead to fewer bleeding risks compared to low molecular weight heparins, indicating a generally favorable safety profile for these drugs in this patient group, but definitive recommendations are not yet established.
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Venous thromboembolism (VTE) remains a critical issue in the management of patients with multiple myeloma (MM), particularly when immunomodulatory drugs (IMiDs) combined with dexamethasone therapy are being prescribed as first-line and relapse therapy. One possible explanation for the persistent high rates of VTE, is the use of inappropriate thromboprophylaxis strategies for patients starting antimyeloma treatment. To tackle the issue, the Intergroupe francophone du myélome (IFM) offered convenient guidance for VTE thromboprophylaxis in MM patients initiating systemic therapy.

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Current evidence-based clinical practice guidelines recommend the use of both low-molecular-weight heparin (LMWH) and direct factor Xa inhibitors (apixapan, edoxaban and rivaroxaban) as first-line options for the treatment of venous thromboembolism (VTE) in patients with cancer. However, most of these guidelines refer to the general cancer patient population and provide limited guidance for specific subgroups of patients at particularly high risk of bleeding, such as those with gastrointestinal cancers, primary or metastatic brain tumors, thrombocytopenia, or renal impairment. In these complex populations, the management of cancer-associated thrombosis (CAT) poses unique challenges and requires a nuanced approach based on the primum non nocere principle.

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The term heparin resistance (HR) is used by clinicians without specific criteria. We performed a literature search and surveyed our SSC membership to better define the term when applied to medical and intensive care unit patients. The most common heparin dosing strategy reported in the literature (53%) and by survey respondents (80.

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Background: The role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in dyslipidemia may go beyond its immediate effects on low-density lipoprotein receptor (LDL-R) activity.

Objective: This study aimed to assess PCSK9-derived alterations of high-density lipoprotein (HDL) physiology, which bear a potential to contribute to cardiovascular risk profile.

Methods: HDL was isolated from 33 patients with familial autosomal dominant hypercholesterolemia (FH), including those carrying PCSK9 gain-of-function (GOF) genetic variants (FH-PCSK9, n = 11), together with two groups of dyslipidemic patients employed as controls and carrying genetic variants in the LDL-R not treated (ntFH-LDLR, n = 11) and treated (tFH-LDLR, n = 11) with statins, and 11 normolipidemic controls.

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Breast cancer is the most common cancer in women. Patients with breast cancer have a 4-fold increased risk of venous thromboembolism (VTE) compared to age- and sex-matched controls without cancer. VTE remains the second leading cause of death in cancer patients and an independent risk factor for mortality.

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Cangrelor is a P2Y12 inhibitor antiplatelet agent, with a rapid onset and offset. The available literature only reviews short-term administration over a few hours. We describe 5 patients who received cangrelor for >1 month in a neurosurgical intensive care unit due to a very high likelihood of requiring emergency revision surgery.

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Anticoagulation of patients supported by extracorporeal membrane oxygenation is challenging because of a high risk of both bleeding and thrombotic complications, and often empirical. Practice in anticoagulation management is therefore highly variable. The scope of this guidance document is to provide clinicians with practical advice on the choice of an anticoagulant agent, dosing, and the optimal anticoagulant monitoring strategy during extracorporeal membrane oxygenation support in adult patients.

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The management of cancer-associated thrombosis (CAT) poses unique challenges to healthcare professionals. While low-molecular weight heparins (LMWHs) have long been the gold standard for both the primary and secondary prevention of CAT, results from large randomized controlled trials assessing the benefit of direct oral anticoagulants (DOACs) in both settings have resulted in some paradigm shifts. Herein, we review and compare recommendations from the latest authoritative clinical practice guidelines (CPGs) for the management of CAT and summarize the most recent evidence on available treatment options.

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The Ottawa score (OS) for predicting the risk of recurrent venous thromboembolism (VTE) in cancer patients with VTE may help to guide anticoagulant treatment decisions that will optimize benefit-risk ratios. However, data on its reliability are conflicting. We applied the OS to all cancer patients with VTE enrolled in the prospective multicenter TROPIQUE study who received low-molecular-weight heparin over a 6-month period.

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Article Synopsis
  • * The 2022 guidelines include specific treatments for patients with cancer and COVID-19, emphasizing low-molecular-weight heparins (LMWHs) and direct oral anticoagulants for managing blood clots.
  • * Key recommendations highlight the use of LMWHs or direct oral anticoagulants for at least 6 months, extended post-surgery prophylaxis, and primary prevention in certain cancer patients undergoing treatment.
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Article Synopsis
  • International guidelines now support the use of direct oral anticoagulants (DOACs) as a viable alternative to low-molecular-weight heparins (LMWHs) for treating cancer-associated thrombosis (CAT).
  • An updated meta-analysis of six randomized controlled trials involving 3,690 patients showed that DOACs significantly reduce the risk of CAT recurrence compared to LMWHs.
  • While DOACs have a slight increase in the risk of major and clinically relevant nonmajor bleeding, they do not affect overall mortality rates in cancer patients.
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Fcγ receptors (FcγRs) interact with the C-reactive protein (CRP) and mediate activation of inflammation-related pathogenic mechanisms affecting cardiovascular health. Our study evaluated whether FcγRIIA and FcγRIIIA profiles are associated with the recurrence of adverse cardiovascular events during the first year after a primary acute coronary syndrome (ACS). The primary endpoint was the recurrence of cardiovascular events (RCE), identified as a composite outcome comprising acute heart failure (AHF) and major adverse cardiovascular events (MACE).

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Article Synopsis
  • The activated clotting time (ACT) is a test to see how long it takes for blood to clot and is important when using a blood thinner called heparin during heart surgeries or procedures.
  • A new medicine called emicizumab helps prevent bleeding in people with hemophilia A and works faster than another medicine, but it doesn’t stop the effects of heparin on ACT.
  • The study showed that even with emicizumab, heparin still makes the ACT longer, meaning doctors can still rely on ACT tests to check how well heparin is working for patients using emicizumab during medical procedures.
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Due to concomitant changes in pro- and anti-coagulant mechanisms, patients with liver dysfunction have a "rebalanced hemostasis", which can easily be tipped toward either a hypo- or a hypercoagulable phenotype. Clinicians are often faced with the question whether patients with chronic liver disease undergoing invasive procedures or surgery and those having active bleeding require correction of the hemostasis abnormalities. Conventional coagulation screening tests, such as the prothrombin time/international normalized ratio and the activated partial thromboplastin time have been demonstrated to have numerous limitations in these patients and do not predict the risk of bleeding prior to high-risk procedures.

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COVID-19 is associated with encephalitis in critically ill patients and endothelial dysfunction seems to contribute to this life-threatening complication. Our objective was to determine the hallmark of endothelial activation in COVID-19-related encephalitis. In an observational study in intensive care unit (ICU), we compared vascular biomarkers of critically ill COVID-19 patients with or without encephalitis.

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Introduction: We aimed to evaluate the performance of the fully automated multiparameter CN-6000 hemostasis analyzer.

Methods: Performance evaluation of the CN-6000 analyzer was conducted for 10 tests including prothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen level, anti-Xa activity, and antithrombin activity using a unique portfolio of liquid ready-to-use reagents. Precision, sample and reagent carryovers, throughput, and sample turnaround time (STAT) function were prospectively assessed.

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