Haemostatic biomarkers for prognosis and prediction of therapy response in patients with metastatic colorectal cancer
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01.03.2020 |
Moik F.
Posch F.
Grilz E.
Scheithauer W.
Pabinger I.
Prager G.
Ay C.
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Thrombosis Research |
10.1016/j.thromres.2020.01.002 |
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© 2020 The Authors Background: Haemostatic activation and hypercoagulability are frequently observed in patients with metastatic colorectal cancer (mCRC), increase risk of venous thromboembolism (VTE) and have been implicated in tumour proliferation and progression. To date, the association of haemostatic biomarkers with oncologic outcomes including overall survival (OS), progression free survival (PFS) and disease control rate (DCR) is incompletely understood. Methods: Within the framework of the Vienna Cancer and Thrombosis Study, a prospective observational cohort study, we conducted an exploratory analysis to investigate the association of six known biomarkers of haemostasis with oncologic outcomes in 99 patients with mCRC prior to chemotherapy initiation. Results: Patients with high levels of factor VIII activity (FVIII), D-dimer, prothrombin fragment 1 + 2 (F1 + 2) and fibrinogen (defined as levels >75th percentile) had significantly shorter median OS than patients with lower levels. Elevation of four biomarkers was associated with mortality in multivariable analysis, adjusting for age, sex, number of metastatic sites and VTE (hazard ratio [95% CI] for death per doubling of levels: FVIII: 2.06 [1.28–3.30]; sP-selectin: 1.55 [1.07–2.24]; D-dimer: 1.40 [1.18–1.65]; F1 + 2: 1.64 [1.10–2.46]). Patients with elevated levels had numerically shorter median PFS across all markers and disease control rate (DCR) was significantly smaller in those with high levels of FVIII and F1 + 2 (adjusted odds ratio [95% CI] for DCR per doubling of levels: 0.23 [0.09–0.62] and 0.36 [0.16–0.82]) compared to patients with lower levels. Conclusion: Specific elevated haemostatic biomarkers are associated with higher mortality and partially with worse response to chemotherapy in patients with mCRC.
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The role of haemostasis in placenta-mediated complications
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01.09.2019 |
Gris J.
Bouvier S.
Cochery-Nouvellon É.
Mercier É.
Mousty È.
Pérez-Martin A.
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Thrombosis Research |
10.1016/S0049-3848(19)30359-7 |
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© 2019 Elsevier Ltd Normal pregnancy is associated with an increasing state of activation of the haemostatic system. This activation state is excessive in women with placenta-mediated pregnancy complications (PMPCs), including preeclampsia (PE). Platelet activation plays a crucial pathophysiological role in PE. The very early activation of coagulation in the intervillous space is mandatory for placental growth and morphogenesis but its excesses and/or inadequate control may participate to the emergence of the trophoblastic phenotype of PE. Extracellular vesicles, of endothelial but also of trophoblastic origin, can favour key cellular reactions of preeclampsia, acting as proactive cofactors. The understanding of this intricate relationship between haemostasis activation and PMPCs may provide interesting keys for new pathophysiological therapeutic developments.
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Pregnancy after in vitro fertilization with the use of allogeneic oocytes in a patient with recurrent pregnancy loss and combined thrombophilia
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01.01.2018 |
Soboleva V.
Trifonova N.
Rudenko Y.
Demura T.
Kogan Y.
Zharkov N.
Zhukova E.
Aleksandrov L.
Ishchenko A.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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© 2018, Dynasty Publishing House. All rights reserved. The article analyzes a favourable outcome of multiple pregnancy achieved after using assisted reproductive technologies and donor egg in a patient with recurrent pregnancy loss and combined thrombophilia.
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New local haemostatic technologies in surgical practice
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01.01.2018 |
Alekseyeva G.
Chilova R.
Kolobaev I.
Kukes V.
Vechorko V.
Tarasov I.
Proklova G.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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© 2018 Dynasty Publishing House. All rights reserved. One of the most important tasks of clinical medicine is to stop bleeding as soon as possible. Despite the broad spectrum of modern haemostatic materials, the available local blood-stopping products are not without certain limitations and shortcomings when used in various clinical situations. The article discusses the potential of «Polygemostat», a Russian haemostatic for external and local use, which simultaneously has an antiseptic and wound-healing effect.
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