Venous Thrombosis – ABC CARDIOL

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Editorial

Serum Levels of sCD40L, CCL3, and NT-proBNP in Elderly Patients Admitted to the Hospital with HF

Maria da Gloria Cruvinel Horta et al. Marcus Carvalho Borin

The authors investigated the serum levels of sCD40L (soluble CD40 Ligand), the pro-inflammatory chemokine CCL3, and N-terminal pro b-type natriuretic peptide (NT-proBNP) in elderly patients admitted to the hospital with HF. The study explored whether screening these biomarkers individually or in combination can serve as a diagnostic tool for HF associated with VTELL. The presence of thrombi was determined through venous ultrasound of the lower limbs during hospital admission. Evaluating 200 patients divided into groups with and without thrombosis, the researchers found that the groups presented similar characteristics, with the exception of lipoprotein levels, which were significantly higher in the thrombosis group. The combined analysis of NT-proBNP, sCD40L, and CCL3 yielded a sensitivity of 62.00% and a specificity of 91.00%. This associated analysis proved superior to the individual performance of each biomarker, utilizing thresholds of 264.93 pg/mL for NT-proBNP, 7.07 ng/mL for sCD40L, and 28.96 ng/L for CCL3, thereby highlighting the diagnostic value of the combination for this specific patient profile.

The relevance of these findings is supported by existing literature, such as the work published by Haller et al., which investigated incremental prognostic outcomes of NT-proBNP plus other biomarkers for risk stratification in patients with atrial fibrillation. Their findings suggested that future use of multiple biomarkers could help distinguish between higher and lower risk levels in complex cardiac patients. Similarly, Folsom et al. conducted a six-year longitudinal follow-up through the “Atherosclerosis Risk in Communities” study, evaluating serial measurements of NT-proBNP. Their data showed that patients with an NT-proBNP increase from 100 to ≥100 pg/mL presented a 1.4 times increased risk for venous thromboembolism compared to those with stable, lower concentrations. When levels were consistently ≥100 pg/mL, the risk rose to 1.6 times. This suggests that rising NT-proBNP levels serve as an indicator of imminent cardiac vulnerability, predisposing patients to thromboembolic events.

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IJCS

Case Report

Massive Pulmonary Embolism After Leg Massage: A Case Report

Stevan Kristian Lionardi et al. Ignatius Ivan Tommy Alexander

Introduction

Venous thromboembolism (VTE) incidents encompass occurrences of both deep vein thrombosis (DVT) and pulmonary embolisms (PE). This occurrence is frequently observed, with an annual incidence rate of 122/100,000 individuals. These two entities share a common pathological pathway, but they are believed to appear in different ways.

In Indonesia, traditional massage is a commonly acknowledged practice applied to individuals experiencing muscle pain or injuries, involving soft tissue manipulation to alleviate pain, induce muscle relaxation, or serve therapeutic purposes as an alternative medical intervention prior to seeking hospital care. Nevertheless, there is limited understanding regarding its effectiveness and safety. Here, we present a case involving a massive PE in a female patient occurring two hours following a traditional lower leg massage, a scenario that has rarely been documented in scientific literature.

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ABC

Research Letter

Endomyocardial Fibrosis as a Rare Cause of Heart Transplantation and its Association with Thrombophilia: A Case Report

Laura Caroline Tavares Hastenteufel et al. Nadine Oliveira Clausell Francine Hehn de Oliveira Santiago Alonso Tobar Leitão Lívia Adams Goldraich

Introduction

Endomyocardial fibrosis (EMF) is a rare disease of unknown etiology characterized by endomyocardial fibrous tissue deposition affecting either one or both ventricles and the atrioventricular valve apparatus. Increased stiffness and progressively reduced diameter of the involved ventricle lead to a restrictive pattern, which appears as heart failure, thromboembolic events, non-fatal arrhythmias, or less frequently, sudden cardiac death.. Though earlier studies report poor survival rates among EMF patients, in contemporary series prognosis, it is uncertain. Genetic, immune, infectious, and environmental factors, among others, have been proposed to explain its pathogenesis; however, there is no consensus on a unified causal theory.^, Despite its poor prognosis and limited disease modifying therapeutic options, endocardectomy among them as a palliative measure, there is a paucity of data in the literature reporting heart transplantation as a therapeutic alternative for patients with EMF. The present study describes the favorable outcome of a patient with EMF who underwent heart transplantation. In the present case, there was also an association of EMF with both factor V Leiden and prothrombin gene mutation as part of the phenotypic presentation, which has not been previously reported.

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ABCIC

Image

Neurovascular Lesion Caused by Non-Lethal Projectile in Cervical Region

Milton Sérgio Bohatch Júnior et al. Amanda Fernandes Vidal da Silva Agnaldo José Graciano

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IJCS

Original Article

SAMe-TT2R2 Score: A Useful Tool in Oral Anticoagulation Decision-Making for Venous Thromboembolism Patients?

Fernando Pivatto Júnior et al. Rafaela Fenalti Salla Lísia Cunha Cé Andréia Biolo … André Luís Ferreira Azeredo da Silva Bruno Führ Luís Carlos Amon Marina Bergamini Blaya Rafael Selbach Scheffel

Abstract

Background:

The SAMe-TT₂R₂ score was introduced to identify atrial fibrillation patients with a high risk of not achieving a good time in therapeutic range (TTR) during vitamin K antagonists (VKA) therapy.

Objective:

The aim of this study was to evaluate this score in venous thromboembolism (VTE) patients.

Patients and methods:

A retrospective cohort study of patients receiving care at the outpatient anticoagulation clinic of a tertiary care teaching hospital. Patients were classified as having low (score 0-1) or high risk (score ≥ 2) of not achieving a good TTR. The area under the ROC curve was calculated to assess the ability of the score to predict a TTR ≥ 65%. Adverse event-free survival curves according to the SAMe-TT₂R₂ score were calculated by the Kaplan-Meier method and compared by the log-rank test. A p-value < 0.05 was considered statistically significant.

Results:

We investigated 111 patients during a median follow-up of 2.3 (0.7-6.4) years. Mean age was 54.1 ± 15.7 years and 71 (64.0%) were women. Low- and high-risk groups had similar mean TTR (51.9 vs. 49.6%; p = 0.593). The two groups did not differ significantly in the percentage of patients achieving a TTR ≥ 65% (35.6 vs. 25.8%; p = 0.370). The c-statistic was 0.595 (p = 0.113) for TTR ≥ 65%. Adverse event-free survival during anticoagulation was also similar in both groups (p = 0.136).

Conclusions:

The SAMe-TT₂R₂ score does not seem to be a useful tool in oral anticoagulation decision-making for patients with VTE and should not be used in this setting.

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ABC

Atualização

Hormonal contraception and cardiovascular system

Milena Bastos Brito et al. Fernando Nobre Carolina Sales Vieira

Hormonal contraception is the most widely used method to prevent unplanned pregnancies. The literature has shown an association between cardiovascular risk and use of hormone therapy. With the purpose of providing better guidelines on contraception methods for women with risk factors for cardiovascular disease, we have reviewed the literature on the subject. This review describes the latest data from the scientific literature concerning the influence of hormonal contraceptives on arterial thrombosis, venous thrombosis and systemic high blood pressure, which are diseases that have become increasingly prevalent among young females.

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Serum Levels of sCD40L, CCL3, and NT-proBNP in Elderly Patients Admitted to the Hospital with HF

Massive Pulmonary Embolism After Leg Massage: A Case Report

Introduction

Endomyocardial Fibrosis as a Rare Cause of Heart Transplantation and its Association with Thrombophilia: A Case Report

Introduction

Neurovascular Lesion Caused by Non-Lethal Projectile in Cervical Region

SAMe-TT2R2 Score: A Useful Tool in Oral Anticoagulation Decision-Making for Venous Thromboembolism Patients?

Abstract

Background:

Objective:

Patients and methods:

Results:

Conclusions:

Hormonal contraception and cardiovascular system

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