Publications by authors named "Pabinger I"
Venous thromboembolism remains a major cause of morbidity and mortality among ambulatory cancer patients, necessitating effective risk assessment and prevention strategies. Despite the availability of risk assessment models and guidelines recommending primary thromboprophylaxis with low-molecular-weight heparins or direct oral anticoagulants, the application of these strategies is inconsistent. This review provides an overview of the current state-of-the-art venous thromboembolism risk assessment and thromboprophylaxis in ambulatory patients with cancer, focusing on existing risk assessment models and the latest guideline recommendations.
View Article and Find Full Text PDFBackground: Patients with cancer treated with immune-checkpoint inhibitors (ICIs) have a substantial risk of venous thromboembolism (VTE). The association between ICI-induced inflammation and hypercoagulability is unclear, and no biomarkers currently exist to stratify VTE risk.
Objectives: The authors sought to determine the association between the early changes in C-reactive protein (CRP) after ICI initiation and the risk of VTE.
Background: Efanesoctocog is a B-domain-deleted, Fc-fusion factor (F)VIII linked to the D'D3 domain of von Willebrand factor and 2 XTEN polypeptides, designed for an ultra-extended half-life for prophylaxis in hemophilia A, but also aiding in managing acute bleeding or surgery in patients on long-term emicizumab. However, no current laboratory method accurately measures FVIII levels in the presence of emicizumab.
Objectives: To test whether the bovine chromogenic FVIII assay, specifically calibrated for efanesoctocog, could provide an accurate assessment of efanesoctocog activity.
Background: Treatment sequence in primary immune thrombocytopenia (ITP) is based on national and international recommendations, treatment availability, and physician expertise.
Aim: This article aimed to provide real-world data on treatment sequence and responses to first- and second-line treatments in newly diagnosed and relapsed adult ITP patients.
Methods: We analyzed a cohort of 46 adult ITP patients from the Vienna ITP Biobank, who started first-line therapy within 1 week before their first study visit between February 2016 and March 2023.
Venous thromboembolism (VTE) is the third most common cardiovascular disease. Clonal haematopoiesis (CH) is linked to cardiovascular disease risk, but its potential association with VTE remains poorly understood. We assessed the prevalence of CH in patients with recurrent VTE (n = 107; median age [IQR] 57 [48-63] years, 44.
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- Human saliva contains extracellular vesicles (EVs) that can activate blood coagulation through the presence of extrinsic tenase complexes, which include tissue factor and activated factor VII.
- Individuals with severe hemophilia A, who lack FVIII, have salivary EVs that can compensate for their condition by generating FXa, leading to infrequent oropharyngeal bleeding.
- In contrast, people with severe FVII deficiency lack these functional extrinsic tenase complexes in their saliva, resulting in more frequent oropharyngeal bleedings; however, adding recombinant FVIIa can restore coagulation potential in their saliva.
Background: Patients with end-stage kidney disease (ESKD) are at very high risk for thromboembolism and bleeding. This study aimed to identify small noncoding RNAs (sncRNAs), specifically microRNAs and transfer-RNA (tRNA)-derived fragments (tRFs), as potential novel biomarkers for predicting thromboembolism and bleeding in this high-risk population.
Methods: In this sncRNA discovery research, we leveraged the VIVALDI cohort, consisting of 625 ESKD patients on hemodialysis, to conduct two nested case-control studies, each comprising 18 participants.
Introduction: Patients with chronic kidney disease, especially those with end-stage kidney disease (ESKD) on hemodialysis (HD), are at increased risk for cardiovascular disease (CVD), including myocardial infarction and ischemic stroke. A shortening in telomere length, as a parameter for accelerated vascular aging, is an established biomarker for CVD in the general population. We aimed to elucidate the role of telomere length in ESKD patient on HD and its association with cardiovascular outcomes.
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- Bleeding disorder of unknown cause (BDUC) is diagnosed after ruling out other causes, and this study analyzed data from 375 BDUC patients compared to 100 healthy controls.
- The findings revealed that BDUC patients had lower peak plasmin levels and clot density, indicating potential issues with clot structure, while still showing a higher potential for plasmin generation.
- A model including fibrinogen and plasmin generation parameters effectively distinguished BDUC patients from healthy controls, demonstrating the potential for predictive diagnostics in bleeding disorders.
Background: Continuously improving cancer-specific survival puts a growing proportion of cancer patients at risk of major adverse cardiovascular events (MACE), but tailored tools for cardiovascular risk prediction remain unavailable.
Objectives: To assess a broad panel of cardiovascular biomarkers and risk factors for the prediction of MACE and cardiovascular death in cancer patients.
Methods: In total, 2192 patients with newly diagnosed or recurrent cancer were followed prospectively for the occurrence of 2-year MACE and 5-year cardiovascular death.
Article Synopsis
- * In a study of 86 ITP patients and 78 healthy controls, findings showed that ITP patients had significantly slower clot lysis times and higher levels of plasminogen activator inhibitor-1 (PAI-1), while tissue plasminogen activator (tPA) levels were lower.
- * The results suggest that prolonged clot lysis time (CLT) and altered fibrinolysis mechanisms in ITP may contribute to thrombosis risk, with specifically higher tPA-PAI-1 complexes indicating potential
Article Synopsis
- * In a study of 791 cancer patients undergoing anti-cancer therapies, 17.6% experienced clinically relevant bleeding (CRB), with significant types including gastrointestinal and tumor-related bleeding.
- * Bleeding events, particularly in those without anticoagulation, were linked to higher mortality rates; patients experiencing CRB had a 5.80 times higher risk of all-cause death compared to those who did not bleed.
Article Synopsis
- Patients with venous thromboembolism (VTE) may suffer from significant anxiety, but this aspect of their health is less researched compared to physical symptoms.
- A study involving 257 patients found that overall anxiety levels decreased over three months, but 23.7% of patients experienced heightened anxiety, especially among older females and those with higher baseline anxiety.
- Factors linked to increased anxiety included being female, being older than 45, having initial anxiety symptoms, while a history of VTE seemed to correlate with lower anxiety, although these findings require further research for conclusive validation.
Article Synopsis
- The study investigates the prevalence and incidence of venous thromboembolism (VTE) in older adults (65+) admitted to long-term care hospitals, highlighting a gap in existing research.
- Researchers analyzed data from 1148 patients, finding a lifetime prevalence of VTE at 9.6% and cumulative incidence rates of 3.5%, 4.2%, and 5.4% over 1, 2, and 3 years, respectively.
- The study concludes that there is a notably high prevalence and incidence of VTE in long-term care settings, indicating the need for more extensive prospective studies to better understand this issue.
: Postpartum haemorrhage (PPH) is a frequent complication of childbirth that is difficult to predict. Predelivery coagulation biomarkers may help to guide preventive strategies. Our objective was to evaluate the association of predelivery haemostatic biomarkers with non-severe PPH.
View Article and Find Full Text PDFFunctional limitations 3 and 12 months after venous thromboembolism: a cohort study.
Res Pract Thromb Haemost
May 2024
Article Synopsis
- Venous thromboembolism (VTE) can lead to long-term complications, prompting a study to evaluate the relationship between initial clinical characteristics at diagnosis and functional limitations at 3 and 12 months post-diagnosis.
- The study involved 307 patients (mostly middle-aged), where assessments showed improvements in functional status over time, but scores remained below pre-VTE levels.
- Female sex, higher body mass index, older age, and pre-existing health conditions were identified as significant factors predicting ongoing functional limitations after VTE.
Article Synopsis
- This guideline offers practical advice for diagnosing and treating haemophilia in Austria, using expert consensus due to a lack of extensive research.
- It is based on the 2020 WFH guideline but tailored to fit national context and experience.
- The document covers diagnosis, treatment, special considerations for children and adults, trauma management, dental procedures, and psychosocial aspects related to haemophilia.
Background: Adeno-associated virus (AAV)-based gene therapy for haemophilia has advanced substantially in the last 13 years; recently, three products have received approvals from regulatory authorities. Although the impact on quality of life seems promising, some limitations remain, such as the presence of pre-existing anti-AAV neutralising antibodies and the occurrence of hepatotoxicity. This review follows the CSL Behring-sponsored symposium at the 27th Congress of the European Hematology Association (EHA) 2022 that examined the haemophilia gene therapy process from a 360-degree multidisciplinary perspective.
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- * A study involving 152 patients with WHO grade IV glioma followed them over two years, identifying 24 patients (16%) who developed VTE, with a case-control analysis of those affected and matched controls.
- * The study found that hsa-miR-451a was the most prevalent miRNA, and identified potential VTE biomarker candidates like hsa-miR-221-3p, providing valuable data for future research in the area.
Introduction: Mucins released from epithelial tumors have been proposed to play a role in cancer-associated thrombosis. Mucin1 (MUC1) is a transmembrane mucin that is overexpressed in a variety of human malignancies, including breast and pancreatic cancer. We analyzed the association of MUC1 and venous thrombosis in a mouse tumor model and in patients with cancer.
View Article and Find Full Text PDFIn many patients referred with significant bleeding phenotype, laboratory testing fails to define any hemostatic abnormalities. Clinical practice with respect to diagnosis and management of this patient cohort poses significant clinical challenges. We recommend that bleeding history in these patients should be objectively assessed using the International Society on Thrombosis and Haemostasis (ISTH) bleeding assessment tool.
View Article and Find Full Text PDFBackground: Data on walking impairment during the acute phase of deep vein thrombosis (DVT) are limited.
Objectives: This study aimed to assess the degree of walking impairment in patients with acute DVT, with a particular focus on the relation to the DVT's anatomical location.
Methods: Patients with sonographically confirmed DVT were eligible for inclusion in this cohort study.