The current issue of Hämostaseologie—Progress in Haemostasis does not include contributions
to a specific topic but several articles that have undergone revision and deserve
publication in this separate issue of the Journal. This edition includes original
articles, images in thrombosis and haemostasis/case reports, and a review.
Original Articles
Venous thromboembolism is an often-recognized complication in cancer patients. Low-molecular-weight
heparin is still considered one of the standard treatments for cancer-associated thrombosis
and was shown to be more efficacious and at least as safe as vitamin K antagonists
(VKAs) for this indication. In the era of direct oral anticoagulants (DOACs), Riess
et al[1] aimed to elucidate the reality of anticoagulation treatment in 7,313 German patients
with cancer. In terms of duration of anticoagulation treatment, prescriptions were
guideline-conform and considered patient prognosis. In terms of selection of anticoagulant
drugs however, the choice of the respective agent was often not in compliance with
the contemporary label or guidelines.
Bleeding after tooth extraction is considered one of the main complications in patients
anticoagulated with DOACs or VKA. The study by von Beckerath et al[2] analyzed nationwide time trends of both oral anticoagulant prescriptions and hospitalization
for tooth extraction in Germany from 2006 through 2017. Results show that the large
increase in oral anticoagulant treatment rates from 2006 to 2017 had only a small
impact on hospitalized tooth extraction cases. At the same time, the number of cases
with long-term anticoagulant use in these cases did not increase after 2014. Relevant
bleeding requiring red blood cell transfusion was rare.
Pulmonary thromboembolism is an important complication of venous thrombosis leading
to severe morbidity and mortality. One possible predisposing factor may be an imbalance
in the coagulation and fibrinolysis system. In the study by Yildiz et al,[3] initial median thrombin-activatable fibrinolysis inhibitor (TAFI) levels were significantly
increased in patients with pulmonary thromboembolism compared to a control group.
Increased TAFI was significantly correlated with pulmonary thromboembolism but not
with treatment outcome.
The synthetic derivative of vasopressin, 1-deamino-8-D-arginine vasopressin (DDAVP),
induces release of factor VIII and von Willebrand factor (VWF) from endothelial cells
and can consequently be used to treat or prevent bleeding in patients with mild hemophilia
A or VWF disorders. So far, no consistent data are available on the interaction of
DDAVP with platelets, although DDAVP may be an efficacious treatment option for some
platelet disorders, too. The effects of DDAVP on the release of platelet microparticles
through platelet activation were studied in 18 patients by Persyn et al.[4] Results of this study were quite heterogeneous showing a clear increase in platelet
microparticles after DDAVP in some patients and no increase in others.
Images in Thrombosis and Hemostasis
Venous thrombosis was widely reported in patients with COVID-19. In this separate
edition of Hämostaseologie, two unusual images of arterial thrombosis related to mild
COVID-19 are illustrated. The first image is a celiac artery thrombosis and splenic
infarction in a 42-year-old female reported by Arslan.[5] The second image is an acute splanchnic arterial thrombosis, spontaneous dissection,
and solid organ infarction in a 57-year-old man reported by Voci et al.[6]
Case Report
Jayant et al[7] report a rare case of spontaneous intraabdominal hemorrhage requiring surgical evacuation
in a 32-year-old Indian man with severe hemophilia A, which was only diagnosed at
the time of bleeding event.
Review
Several studies have investigated the role of different DOACs in the treatment of
patients with acute or chronic coronary artery disease, and with atrial fibrillation
undergoing percutaneous coronary intervention. The review by Al Said et al[8] provides an excellent comprehensive summary of these most recent clinical studies
that is worth reading.
On behalf of the Editorial Board Members, we thank all authors for their great contribution
to this issue of Hämostaseologie—Progress in Haemostasis. We would also like to take
this opportunity to thank all colleagues who, through their commitment, ensure a professional
review of submitted articles. Last but not least, we also thank our loyal readers
for their trust in this Journal.
