Publications by authors named "V Toschi"

The last decade has seen a significant increase in the number of long survivors after a hematologic cancer, both children and adults, due to significant improvement in treatment. This exciting result, however, has been associated with an increase in the occurrence of previously unknown cardiovascular complications, including acute myocardial infarction, stroke, heart failure, deep vein thrombosis and pulmonary embolism. These adverse outcomes are due to both the hematologic cancer per se and to antineoplastic therapy.

View Article and Find Full Text PDF

In the era of direct oral anticoagulants, vitamin K antagonists retain a clinically relevant role in thrombotic disorders. In Italy, approximately 20% of the patients on anticoagulant therapies receives a VKA, in most cases warfarin. The optimal management of this drug is challenging and cannot disregard its intricate and unpredictable pharmacokinetic properties and patient's thrombotic and bleeding risk.

View Article and Find Full Text PDF

Heparin-induced thrombocytopenia (HIT) is a potentially fatal, immune-mediated adverse drug reaction to heparin (both unfractionated and low molecular weight heparin) which is caused by the formation of IgG antibodies against an epitope composed by platelet-derived PF4 and heparin. Binding of IgG to PF4/heparin neoantigen induces platelet activation which may cause venous or arterial thrombosis, associated with thrombocytopenia. HIT diagnosis is based on both pre-test clinical probability evaluation and the detection of platelet activating antibodies.

View Article and Find Full Text PDF

Patients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. About a quarter of the anticoagulated patients require temporary cessation of direct oral anticoagulants (DOACs) or vitamin K antagonists for a planned intervention within 2 years from anticoagulation inception. Several clinical issues about DOAC interruption remain unanswered: many questions are tentatively addressed daily by thousands of physicians worldwide through an experience-based balancing of thrombotic and bleeding risks.

View Article and Find Full Text PDF