#AQUATICtrial In chronic coronary syndrome pts at high 🫀atherothrombotic risk on long-term oral anticoagulation (OAC), adding ASA ↑ CV events (HR 1.53), death (HR 1.72) & major bleeding (HR 3.35) without benefit. OAC alone safer. Published in @nejm.org www.nejm.org/doi/full/10....

📢 New in @NEJM: In patients with provoked VTE + enduring risks, 12 mo of low-dose apixaban cut recurrent VTE by ~90% (1.3% vs 10.0%) 🩸 Major bleeding rare (1 pt). 👉 www.nejm.org/doi/full/10....

Radiotherapy may independently increase the risk of venous thromboembolism. 🩸⚡ This review in @rpth.bsky.social unpacks mechanisms, diagnostic challenges, and why thromboprophylaxis should be tailored rather than routine. 👉 doi.org/10.1016/j.rp... #Thrombosis #Oncology #CancerResearch

A new @thrombosiscan.bsky.social survey found that >50% of Canadian cancer patients have little or no awareness of cancer-associated thrombosis (CAT) — a major cause of death in cancer. 📊 Only 27% recalled being educated on CAT risks, yet most want more info! doi.org/10.1055/a-26...

☀️ A morning walk, fresh air, and great company – the perfect way to kick off a busy day at #ASHCRTI! 🏃‍♀️💬 Nothing like connecting with colleagues and faculty before diving into a full day of learning. Thanks to everyone who joined us this morning! 🙌 @ash.hematology.org

🧵1/ Diagnosing recurrent venous thromboembolism (VTE) is hard. The international, multicenter PREDICTORS study (n=723) shows that while clinical decision rules (CDRs) still help stratify risk, they’re less effective at ruling out recurrence without imaging. 🩺📉

🆕 A new study protocol START aims to investigate the best strategies to reduce risk of thrombosis and thrombocytopenia in cancer patients. @marccarriermd.bsky.social 👉 Click here to read more about the study design and goals! www.rpthjournal.org/article/S247...

Implementation matters! A guideline-driven VTE prevention program (Vermont Model) led to ~60% of high-risk cancer patients receiving prophylactic anticoagulation—resulting in a 60% reduction in VTE and 56% reduction in death. #ISTH2025 #VTEprevention 🩸 @marycushmanmd.bsky.social

🚨 SPECTACULAR RCT at #ISTH2025! Although non-inferiority to CTPA wasn’t shown, a negative SPECT V/Q scan led to low 3-month VTE risk— ✅ Supporting the safety of ruling out PE with a SPECT-based algorithm 📸 PE diagnosis rates matched other validated strategies SPECTacular findings indeed! 🫁💥

🩸 WaVE Study Alert! In patients with acute CAT & weight >90kg, weight-based dalteparin (200 IU/kg) appears safe & effective. 🔹 Anti-Xa levels aligned with non-obese patients 🔹 Higher levels seen in those with bleeding Important data to guide dosing CAT & obesity. 📍Presented by Dr. Wang at #ISTH2025

📣 ARIVA Trial at #ISTH2025: 🧪 First RCT on antithrombotic therapy post-venous stenting for PTS 🔵 6-month primary patency rate was higher than expected 💊 No added benefit of aspirin + rivaroxaban vs. rivaroxaban alone www.ahajournals.org/doi/10.1161/...

📢 Long-term results from the CELEST trial presented at #ISTH2025: 🧦 No difference in burdensome PTS (~10%) between 25 vs. 35 mmHg ECS after proximal DVT. ✅ Compliance (>50% use) significantly lowers risk. 🔁 Findings reinforce 2-year RCT data. 📌 A placebo-controlled RCT is still needed.

Great provocative SOA by Dr. Eikeilboom: are there settings where warfarin outperforms DOACs in AF?💊 Emerging data suggest lower mortality & better overall clinical benefit in AF with obesity or rheumatic disease, possibly via GAS6 inhibition #ISTH2025 #AF #Thrombosis

🩸 Important findings from Dr @IMYanXu at #ISTH2025: Black individuals on extended anticoagulation for secondary VTE prevention had higher rates of major bleeding, including ICH, than White individuals. 🔎 No difference in CRNMB. 📢 Calls for action to address racial disparities.

🧠 #ISTH2025 SCC survey on stroke in cancer patients: 1️⃣ Physicians choose reperfusion strategies differently for patients with vs. without cancer 2️⃣ Antiplatelets remain the most used for secondary prevention 3️⃣ Major equipoise on workup post-stroke in cancer what is the standard of care?

🩸 New insights from the RENOVE trial (extended duration anticoagulation) at #ISTH2025: 📉 Reduced-dose DOAC is non-inferior in patients with BMI <30, with less bleeding risk. ⚠️ But in patients with BMI ≥30, reduced-dose may be inferior for bleeding and recurrent VTE. ➡️ Dose matters! @isth.org

Meta-analysis on GLP-1RA (vs. placebo) and VTE: 🔹 PE rates significantly lower 📉 🔹 VTE rates lower but not statistically significant 🔹 No difference in DVT 🔹 Study design matters: RCTs vs. observational data Accepted for publication in JTH! #ISTH2025 #VTE #GLP1RA #Thrombosis @jthjournal.bsky.social

Come say hello to David Airdrie, our Executive Director at Thrombosis Canada, at Booth 623! 👋 Learn more about our clinical guides, patient resources, and upcoming education initiatives. 📍 #ISTH2025 We’re here to connect! #ThrombosisCanada #VTE @thrombosiscan.bsky.social

📉 GLP-1RA linked to ~25% lower VTE risk vs. other weight-loss meds in a target trial emulation. ⚖️ No difference when compared to bariatric surgery. Important findings on obesity, meds, and thrombosis risk. #ISTH2025 #VTE #GLP1RA

📢 Adjust-DVT delivers practice-changing evidence! Age-adjusted D-dimer safely rules out DVT in patients with low or non-high pretest probability—reducing the need for ultrasounds. ✅ +17% yield in patients ≥75 years #ISTH2025 #DVT #Thrombosis #VTE

🩸 Clots strike twice—often in the same place. In a study of 708 patients with prior VTE, most recurrent events occurred at the same site as the original, especially in the same leg for prior DVT. #ISTH2025 #VTE #DVT #Thrombosis

🫁 A COPD-specific PE diagnostic strategy was retrospectively validated and shown to be safe. Using a simple 3-item score + D-dimer (2 cut-offs), 50% of patients could avoid imaging. 🔹 DVT signs 🔹 Non-purulent AECOPD 🔹 PE as most likely dx #ISTH2025 #VTE #COPD

📸 The Ottawa Thrombosis teams out celebrating wins and milestones at #ISTH2025! Proud of the science, the teamwork, and this amazing community. 🩸🥂

🩸 A new meta-analysis presented at #ISTH2025 and published in European Heart Journal identifies key risk factors (e.g., prior VTE or bleeding, advanced cancer, and certain cancer sites) linked to recurrent VTE and bleeding in patients with CAT 🔗 academic.oup.com/eurheartj/ad...

🩸 Curious if abiraterone interacts with DOACs in cancer patients? A large population-based study in men with prostate cancer found no increased bleeding risk with concurrent abiraterone + DOACs vs. other anticoagulants. 📍 #ISTH2025 📸 See findings below 👇

Tissue factor (TF) >130 pg/mL in acute PE = higher death risk. TF may enhance risk scores & guide targeted therapies. Larger trials are warranted. Important insights from #ISTH2025 📷⬇️

This is what we were waiting for. A direct comparison between apixaban and rivaroxaban for the treatment of acute VTE. Apixaban reduces bleeding risk in the first 3 months by >50%! Practice changing investigator-initiated RCT. #ISTH2025

VTE isn’t “over” at discharge. Many patients face lasting symptoms & distress. 🗣️ PROMs help reveal what matters, if we use them right. ✅ Ask ✅ Act ✅ Guide care Structured models like Attend-PE show the way. #ISTH2025 #Thrombosis #PatientVoice

📈 Disparities in #VTE care remain a major challenge. 🧬 Race, income, region & rurality affect: • Incidence • Access to DOACs • Mortality rates We need targeted solutions rooted in data & equity. #ISTH2025 #HealthEquity #Thrombosis

In non-critically ill COVID-19 patients, therapeutic-dose anticoagulation reduced the odds of organ support, thrombosis, or death at 28 days. 🔴 Bleeding risk increased, but absolute risk stayed low. No high-credibility effect modifiers identified. 👏 Nice work @TritschlerMD #ISTH2025 #COVID19 #VTE

New network meta-analysis on thromboprophylaxis in medical inpatients: ✅ LMWH works well ⚠️ DOACs & UFH are effective, but less safe ⏱️ Duration ≥6 days 🔍 Emphasizes the need for baseline risk stratification #VTE #Thrombosis #ISTH2025

⏱️ In intermediate–high risk PE, delaying anticoagulation can be deadly. A doubling in time to start treatment = 2.7 X higher risk of PE-related death. Act fast. #VTE #PulmonaryEmbolism #ISTH2025

🧬 Thinking about thrombophilia testing? It’s not just about who to test — but which test to use! The latest ISTH SSC guidance outlines best practices and recommendations for lab selection and testing reliability. Check it out before you test. #ISTH2025 @isth.org

🚨Calling all ISTH members! The SSC is seeking new Subcommittee Co-Chairs to join its vital scientific mission. This is a unique opportunity to collaborate with experts, drive scientific progress, and serve the global ISTH community. Click here to learn more: www.isth.org/news/news.as...

Pregnancy-Related VTE Risk Perception & Prevention in Risk-Averse Times—Significant Change Required vimeo.com/1072760896 @btsamuelsonmd.bsky.social @marccarriermd.bsky.social @isth.org @worldthrombosisday.bsky.social @thrombosisuk.bsky.social @jeanconnorsmd.bsky.social @bsochaem.bsky.social

🎉 A huge thank you to our incredible Adult Thrombosis Medicine International Fellows at @uottawa.ca ! We're proud to celebrate the end of your training and a truly successful year. Your dedication and impact have been outstanding. 👏🩺🌍 @canvector.bsky.social @isth.org

Have you ever wondered about the long-term risk of recurrence in patients with isolated SSPE? Fresh data suggest the risk may not exceed the threshold for extended anticoagulation—but decisions should be made on a case-by-case basis. 👉 www.sciencedirect.com/science/arti...

🚨 New study alert: Attempting FXa inhibitor reversal with andexanet before urgent cardiac surgery may lead to heparin resistance. Caution is needed! Elegant editorial reviewing the mechanisms www.sciencedirect.com/science/arti... 🫀 #MedTwitter #CardioTwitter #VTE @jthjournal.bsky.social @isth.org

Prof. @isabellemahe.bsky.social presents API-CAT at @accintouch.bsky.social published in @nejm.org: Extended anticoagulation with reduced-dose apixaban is noninferior to full-dose for preventing recurrent VTE, with less clinically relevant bleeding 🩸in cancer patients www.nejm.org/doi/full/10....

Prof. @isabellemahe.bsky.social presents API-CAT at @accintouch.bsky.social published in @nejm.org: Extended anticoagulation with reduced-dose apixaban is noninferior to full-dose for preventing recurrent VTE, with less clinically relevant bleeding 🩸in cancer patients www.nejm.org/doi/full/10....

The Repeat Study addressed a really important knowledge gap! The incidence of recurrent events following an ante- or postpartum VTE is 2.4% person-years. The cumulative risks are 6%, 13%, 17%, and 30% at 2, 5, 10, and 30 years respectively www.jthjournal.org/article/S153... @jthjournal.bsky.social

The RENOVE trial found that while low-dose DOACs did not meet non-inferiority for preventing recurrent VTE, it showed a better risk-benefit ratio, with less clinically relevant bleeding. Dose reduction may be a good option for many patients! www.thelancet.com/journals/lan... @thelancet.bsky.social

Cancer-associated thrombosis is not only about venous events. Patients with cancer and no prior strokes have a 1.5 ⬆️risk of ischemic stroke compared to those without cancer. ⬆️risk with certain tumor types. www.sciencedirect.com/science/arti... @drdebthrombo.bsky.social @jthjournal.bsky.social

Did you know? Around 50% of patients with acute CAT in your practice do not meet the inclusion criteria of the RCTs. Listen to the podcast with @gbarnesmd.bsky.social about recent trials taking a more pragmatic approach. www.medthority.com/medical-educ...

Interesting results with abelacimab in patients with A Fib @NEJM👇 Can uncoupling hemostasis and thrombosis by blocking activation of FXI also help address unmet needs in cancer-associated thrombosis? Can’t wait to see the results of the on-going ASTER and MAGNOLIA trials www.nejm.org/doi/full/10....

RENOVE trial Reduced dose DOAC was not non inferior to full dose (2.2% vs 1.8%, P=0.23) but lower risk of clinically relevant bleeding (9.9 vs 15.2%) for extended duration anticoagulation for the secondary prevention of recurrent VTE Risk benefit seems to favor reduced dosing for most patients

Do you wonder about the long term rates of complications in patients with SSPE (No DVT) managed without anticoagulation? Relatively low risk of recurrent VTE and no CTEPH. Small sample size and needs confirmation but hypothesis generating. #ASH24

Dr. Li reported external validation of the EHR-CAT score (adaptions of the Khorana risk score) in 187 health care system (over 400,000 patients). Let’s implement this in EPIC to stratify patients according to their underlying risk of VTE! #ASH24

How to troubleshoot heparin resistance? 1) Consider the dosing strategy 2) Understand the testing platforms 3) Determine the etiology 4) Consider one of the different management options #ASH24