Journal of Thrombosis and Haemostasis (J THROMB HAEMOST)

Publisher: International Society on Thrombosis and Haemostasis, Wiley

Journal description

The mission of the new Journal of Thrombosis and Haemostasis will be to advance science related to the important medical problems of thrombosis, bleeding disorders and vascular biology through the diffusion and exchange of information and ideas within the international research community. The Journal publishes high quality, original research reports, state-of-the art reviews, invited commentary and debate on timely topics, letters and announcements. Editors invite both laboratory and clinical reports. The Journal of Thrombosis and Haemostasis is now available in print and online.

Current impact factor: 5.55

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 5.55
2012 Impact Factor 6.081
2011 Impact Factor 5.731
2010 Impact Factor 5.439
2009 Impact Factor 6.069
2008 Impact Factor 6.291
2007 Impact Factor 5.947
2006 Impact Factor 5.138
2005 Impact Factor 5.262
2004 Impact Factor 4.831
2003 Impact Factor

Impact factor over time

Impact factor
Year

Additional details

5-year impact 6.18
Cited half-life 5.10
Immediacy index 1.17
Eigenfactor 0.05
Article influence 2.06
Website Journal of Thrombosis and Haemostasis website
Other titles Journal of thrombosis and haemostasis, JTH
ISSN 1538-7933
OCLC 48955697
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

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  • Post-print
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  • Restrictions
    • 12 months embargo
  • Conditions
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    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
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    • On a non-profit server
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    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Despite being a major source of morbidity in patients with deep vein thrombosis (DVT), the perceived importance of post thrombotic syndrome (PTS) as a clinical outcome by physicians is unknown. Aims: To determine whether treating clinicians feel that PTS and severe PTS are a relevant endpoint. Methods: An internet survey was distributed to the members of Thrombosis Canada and The Society of Vascular Surgeons of Canada. The survey was open from Aug. 2014-Oct. 2014. Responses were obtained on a 5 point Likert scale with references: 1(irrelevant), 3 (important) and 5(very important) or as multiple options ‘yes’, ‘no’ or ‘uncertain’. Stastistics calculated by Chi squared analysis. Results: Of the 235 initially contacted 84 (36%) answered the survey (51 internists and 33 vascular surgeons). Any PTS was ranked as significantly less important as an outcome than recurrent DVT, PE during treatment, major bleeding, death, quality of life, venous ulceration and severe PTS (all P < 0.05). No major differences were noted between surgeons and non-surgeons in how they perceived the importance of outcomes except for recurrent DVT, which was ranked as less important by surgeons as compared to internists (P < 0.0001). When presented with the results of the CaVenT study by Enden et al. (Lancet 2012), clinicians were divided on whether a 14% absolute reduction in PTS was clinically relevant, with similar numbers answering: Yes 38%, Uncertain 34%, and No 28% (P = 0.59). There was a trend towards surgeons being more likely to feel that a change of 14% was relevant compared to internists (P = 0.14). Conclusion: Our survey determined that PTS in general is not appreciated as an important endpoint as compared to other clinical outcomes, however, severe PTS is considered important. Results of upcoming DVT treatment studies exploring more aggressive endovascular strategies to prevent PTS may not lead to a change in current practice unless they are adequately powered to show differences in more relevant clinical outcomes, including severe PTS.
    Journal of Thrombosis and Haemostasis 06/2015; DOI:10.1111/jth.12993.
  • Sean G Yates, Ravi Sarode
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    ABSTRACT: Vitamin K antagonists have been used as oral anticoagulants in the treatment and prevention of thromboembolic events for over half a century. Although vitamin K antagonists are effective in the management of thromboembolic events, the need for routine monitoring and the associated risk of bleeding has resulted in the development and licensing of direct oral anticoagulants for specific clinical indications. Despite these developments, vitamin K antagonists remain the oral anticoagulants of choice in many clinical conditions. Severe bleeding associated with oral anticoagulation requires urgent reversal. Several options for the reversal of vitamin K antagonist exist, including vitamin K, prothrombin complex concentrates and plasma. In this manuscript, we review current evidence and provide physicians with treatment strategies for more effective management of vitamin K antagonist-associated bleeding.
    Journal of Thrombosis and Haemostasis 06/2015; Volume 13(Issue Supplement S1):Pages S1–S369. DOI:10.1111/jth.12970
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    ABSTRACT: Background: Hypercoagulability syndromes (HS), which are genetic or acquired syndromes with a defined abnormality involving a component of the coagulation cascade, are well known causes of venous thromboembolism (VTE). Warfarin is the most common medication used for the treatment of VTE. It is not known if a difference exists in the dose and time needed to achieve therapeutic anticoagulation between patients with and without HS. Aims: To analyze the difference in the dose of warfarin and the time required to reach the target therapeutic international normalized ratio (INR) between patients with and without HS who are managed for VTE. Methods: An institutional review board approved case control study was conducted at our hospital. Inpatient and outpatient charts from January 2002 to December 2012 were reviewed. A total of 622 patients met our inclusion criteria. Two groups were compared: Group 1 were VTE patients with a secondary International Classification of Diseases, Ninth Revision, code for HS and Group 2 were patients with VTE without a secondary HS diagnosis, i.e. control group. Results: A total of 125 cases in Group 1 and 497 in Group 2 were analyzed. Univariate (P < .2) and multivariate analyses (P ≤ .05) were performed with the primary aim of comparing Group 1 to Group 2. The dose of warfarin required to reach therapeutic INR in Group 1 was higher (50.7 � 17.6 mg) compared to Group 2 (41.2 � 17.7 mg). The difference was statistically significant (P < .001).The total number of days required to reach therapeutic INR in Group 1 was (8.9 � 3.5 days) as compared to (6.8 � 2.9 days) in Group 2. The difference was statistically significant (P < .001). Conclusion: Our study suggests that patients with HS require a higher dose of warfarin and a longer time to reach therapeutic INR. This study suggests that more attention is needed when managing patients with HS to ensure proper and timely anticoagulation. Disclosure of Interest: None declared.
    Journal of Thrombosis and Haemostasis 06/2015; 13(Supplement S2):987.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: General awareness of venous thromboembolism (VTE), risk factors and prevention is currently very low in Australia. Patient and their family engagement is critical to improving health care outcomes and reducing health care costs. Aims: To evaluate consumer awareness of VTE risk and assess the importance of the patient point of view on VTE prevention. Methods: In total 1018 Australian people completed a series of online VTE questions in June 2013. Participants requiring surgery or an extended hospital length of stay in the last 3 years, or be planning to have surgery or an extended in-hospital stay in the next 2 years were included. All participants were screened ensuring genuine responses. In the course of the survey VTE was explained to all research participants. Results: Overall 2% of patients were concerned about VTE. Most (30%) patients were more uneasy about the effects of anaesthetic or in-hospital acquired infections. VTE risk was mentioned by a health care provider (HCP) in 36% of cases and was less likely raised in a public (28%) than a private (41%) hospital. It was also more likely to have been mentioned for elective surgery (44%) than for maternity patients (5%). Once participants were aware of the VTE risk, 84% were extremely or very likely to prefer to go to a hospital with ‘best practice’ VTE prevention. This was favoured even if it equated to inconvenience for visitors (42%), further travel (36%), expensive treatment (25%) or changing surgeons (22%). Conclusion: These findings highlight the importance of active discussion between HCP, patients and their families to increase community VTE awareness. Appropriate risk assessment is key to implementing appropriate prophylactic measures. Patient education on their VTE personal risk profile, family history, use of preventative measures and compliance is critical to VTE risk reduction. Engaging clinicians and creating accountable institutions is key to minimising the burden of VTE.
    Journal of Thrombosis and Haemostasis 06/2015; 13(Suppl 2):981.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Pancreatic cancer is associated with the highest thrombotic rates (17% to 57%) amongst any other gastrointestinal cancers. Aims: To assess the incidence of thrombotic events, efficacy of thromboprophylaxis and associated bleeding complications. Methods: In total, 182 patients were retrospectively reviewed (2002– 2014) that underwent pancreaticoduodenectomy for benign or confirmed malignancy. Demographics, diagnosis, venous thromboembolism (VTE) risk, hospital length of stay (LOS), operative duration, prophylactic modalities used and bleeding complications were assessed. In-hospital and 1 year readmission rate of all thromboembolic events were evaluated. This included portal vein thrombosis (PVT), upper-extremity deep vein thrombosis (UEDVT), lower extremity deep vein thrombosis (LEDVT) as well as pulmonary embolism (PE). Results: Male to female ratio was 1.4: 1 with a median age of 63 years (55–71) and LOS of 20 days (12–31). Median operative duration was 4.5 h (3.8–6.3). Tumour localisation was mainly in the head of pancreas (39.6%) and ampulla of vater (15.4%). Unfractionated heparin (UH) was used in 84.6% of patients, 7.7% received low molecular weight heparin (LMWH) and 7.7% used UH followed by LMWH. All received mechanical prophylaxis. Major bleeding occurred in 22.7% of patients on UH. In-hospital incidence for thrombosis was 7.1%, 2.2% for PVT, 2.7% for UEDVT, 1.1% for LEDVT and 1.1% for non fatal PE. The 1 year thrombotic incidence was 9.9% with 27.8% of late VTE events detected post hospitalization. VTE accounted for 5.4% of all readmissions. 1 year mortality was 23.1%. Conclusion: The rate of in-hospital thrombotic events was relatively low highlighting the importance of optimal in-hospital thromboprophylaxis relative to risk factors, tumour grade, chemotherapy and/or radiotherapy, operative duration, LOS and bleeding risk. The out of hospital increase in thrombotic events suggests that high risk patients may possibly benefit from post-discharge thromboprophylaxis.
    Journal of Thrombosis and Haemostasis 06/2015; 13(Suppl 2):977.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Although multislice CT angiography (CTPA) can safely rule out pulmonary embolism (PE) without the need of additional leg ultrasonography (CUS) in outpatients, in a preliminary study we recently observed that in hospitalized patients with suspected PE ruled out by CTPA the prevalence of deep vein thrombosis (DVT) was increased up to six percent. Aims: To provide a more accurate estimate of the prevalence DVT in hospitalized patients with suspected PE ruled out by CTPA. Methods: Prospective single center cohort study. Patients were included if they had developed symptoms compatible with PE more than 48 h after being admitted to hospital for any reason other than PE or more than> 24 h after being admitted for a major surgical intervention (general anesthesia time > 90 min). All participants were evaluated with CTPA (64-slice or greater scanner). Patients were excluded if they had symptoms compatible with PE prior to admission. After providing written consent, all patients were evaluated with bilateral whole leg CUS. Results: Between November 2011 to December 2014, 176 hospitalized patients were included (average 1.1 patients per week). Forty three percent had active cancer, 58% had major surgery and 77.3% were on thrombo-prophylaxis). Shortness of breath was the presenting symptom in 73.3% of the patients, 22.2% had symptoms of DVT and 48.2% had a Wells score > 4 points. The overall prevalence of PE was 35.8% (95% CI 28.7–43.4), and 11% (95% CI 4.5–21.5) in those with a Wells score ≤ 4. The prevalence of proximal DVT was 15.9% (95% CI 7.8–27.2) in those with PE vs. 7.07% (95% CI 3.1–13.4) in those without PE; the incidence of distal DVT 20.6% in those with PE vs. 5.4% in those without PE. In those without PE, the presence of symptoms of DVT increased the risk proximal DVT (RR 5.9; 95% CI 3.2–10.7). Conclusion: Given the high prevalence of proximal DVT in hospitalized patients in whom PE is ruled out by a negative CTPA, a proximal bilateral CUS could be required to safely exclude PE.
    Journal of Thrombosis and Haemostasis 06/2015; Suppl 2.
  • Journal of Thrombosis and Haemostasis 06/2015; 13(S2). DOI:10.1111/jth.12993
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    ABSTRACT: Background: Prior meta-analysis and observational studies have suggested that the bleeding risk associated with vitamin K antagonists (VKA) targeting an INR between 2–3 and aspirin have the same risk bleeding risk, independent of the indication. Aims: To provide the odds ratios (ORs) of major bleeding (primary outcome), intracranial bleeding and fatal bleeding episodes, and overall mortalityassociated with the use of VKA or ASA. Methods: We conducted a systematic review Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (RCT), from 1946 to May 28th 2014.RCTs reporting bleeding rates in adult patients randomized to a VKA [mean target International Normalized Ratio (INR) between 2–3 without concomitant ASA], or to ASA alone (< 325 mg daily), with at least 3 months of follow-up were included. Random effects ORs and their associated 95% confidence intervals (CIs) were calculated. Results: Fifteen RCTs reporting the outcome of 2549 participants treated with VKA alone and 2471 treated with ASA alone were included; most common conditions evaluated were non-valvular atrial fibrillation (five trials) and heart failure (three trials). The use of vitamin K antagonists was associated with an increased risk of major bleeding random effects pooled OR1.76 (95% CI 1.24–2.48; I² 10.8%). Allcause mortality was similar between those treated with VKA and ASA, random effects pooled OR 0.95 (95% CI 0.8–1.13; I² 0%) whereas the risk of intracranial bleeding random effects pooled appeared to be increased in those receiving VKA OR 1.74 (95% CI 0.83–3.62; I² 0%) but not the risk of fatal bleeding OR 1.25; (95% CI 0.4–3.92; I² 0%). Conclusion: Contraryto prior reports, our results suggest that the risk of major bleeding with the use VKA is higher compared to patients treated with ASA alone, with a trend towards an increased risk of intracranial bleeding.
    Journal of Thrombosis and Haemostasis 06/2015; Suppl 2.
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    ABSTRACT: Background: Hepatectomy patients are at significant risk of venous thromboembolism (VTE). Pulmonary embolism (PE) rates have been reported to be as high as 6%. Concerns on the use of pharmacological prophylaxis due to post-operative liver dysfunction and bleeding remain an issue. Aims: To determine the incidence of VTE following hepatectomy as well as the efficacy of prophylactic modalities used and associated bleeding complications. Methods: In total, 265 patients were retrospectively reviewed between 2005 to 2014 that underwent hepatectomy for benign or confirmed malignancy. Demographic details, diagnosis, VTE risk, hospital length of stay (LOS), operative details, prophylactic modalities used and bleeding complications were collected and analyzed. Thrombotic events included the in-hospital and 1 year incidence of deep vein thrombosis (DVT), pulmonary embolism (PE) and portal vein thrombosis (PVT). Results: Male to female ratio was 1.4:1 with a median age of 59 years (50–68.5) and LOS of 8 days (6–12). Median operative duration was 4 h (2.9–5.3). The majority (83.1%) of patients underwent surgery for malignancy. All patients received mechanical prophylaxis, 89.5% received unfractionated heparin (UH), 2.6% low molecular weight heparin (LMWH) and 7.9% UH followed by LMWH. 14.7% of patients on UH had a major bleed. The in-hospital thrombotic rate was 1.9%, 0.8% for PVT and 1.1% for non-fatal PE. At 1 year the incidence of thrombotic events was 3.1%, 0.8% for PVT, 0.4% for DVT and 1.9% for non-fatal PE. Post-hepatectomy after discharge VTE accounted for 50% of all events. Mortality at 30 days was 1.1%. Conclusion: The in-hospital VTE rate was kept relatively low with use of prophylactic protocols. Late VTE events occurred after hospitalization with results revealing an almost two fold increase in PE at 1 year. These findings suggest that selective use of post discharge pharmacological prophylaxis post-hepatectomy in patients that are clearly identifiable as high risk may be beneficial.
    Journal of Thrombosis and Haemostasis 06/2015; 13(Suppl 2):981.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Recommendations for using anticoagulants and endovascular thrombus reduction (ETR) strategies for the treatment of deep vein thrombosis (DVT) and preventing post thrombotic syndrome (PTS) vary between different specialties. Aims: To determine whether there is a difference in the approach to management and prevention of DVT/PTS between internists and vascular surgeons. Methods: A self-completed electronic survey with case scenarios was distributed to members of Thrombosis Canada and the Canadian Society for Vascular Surgery from Aug.-Oct. 2014. Results: Of the 235 contacted, 84 (36%) answered the survey (51 internists and 33 surgeons). For management of ilio-femoral DVT, internists were less likely than surgeons to recommend ETR (45 vs.86%; P = 0.0005), even for scenarios when a patient expressed concern about PTS. In patients with popliteal DVT, both internists and surgeons favour the use of anticoagulation as first line treatment, although surgeons were less likely to prescribe new oral anticoagulants (vs. warfarin) compared to internists (6 vs. 65%; P < 0.0001). A similar proportion of internists and surgeons would recommend the use of ETR in patients with popliteal DVT concerned about PTS. There was no difference in the prescription of graduated compression stockings (GCS) between groups (P = 0.14). Surgeons had better access to endovascular procedures for DVT than internists (97% vs. 53%; P < 0.0001). For surgeons, the primary barrier to prescribing ETR reported was MD unfamiliarity with indications for the procedure (27%), while for internists, it was lack of trained personnel (22%). Conclusion: Our survey found significant practice variation between internists and vascular surgeons for the treatment of DVT and prevention of PTS; both groups continue to frequently use GCS despite the findings of recent studies. Future studies should address how to improve knowledge translation in order to ensure evidence based care is prescribed to patients with DVT regardless of the speciality of the treating physician. Disclosure of Interest: None declared.
    Journal of Thrombosis and Haemostasis 06/2015; Suppl 2.
  • Journal of Thrombosis and Haemostasis 03/2015; 13(3):490-490. DOI:10.1111/jth.12848
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    ABSTRACT: The striking coagulopathy in patients with severe sepsis and the increasing insight into the intricate link between inflammation and coagulation has been an inspiration for many researchers and pharmaceutical companies to explore potential therapeutic interventions for severe sepsis [1]. Indeed, in view of the high incidence of severe sepsis and sepsis mortality ranging from 20 to 50%, there is a urgent need for better treatment options [2]. As dysfunctional physiological anticoagulant regulators, such as antithrombin, activated protein C, and tissue factor pathway inhibitor, were shown to be key players in the sepsis-associated activation of coagulation, and animal studies supported the hypothesis that restoration of these pathways resulted in attenuation of coagulopathy and organ dysfunction and reduced mortality, large clinical studies were performed to establish the beneficial effect of these interventions in patients with severe sepsis [2-5]. Although some of these studies demonstrated some advantage in subgroups of patients with most extreme coagulopathies an overall reduction in mortality was not confirmed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Thrombosis and Haemostasis 02/2015; 13(4). DOI:10.1111/jth.12868
  • Journal of Thrombosis and Haemostasis 09/2014; 12(9):1574-1575. DOI:10.1111/jth.12666
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    ABSTRACT: Thrombosis of a cardiac valve prosthesis is a potentially life threatening but thankfully relatively rare complication following heart valve replacement. Management of this difficult situation is either by repeat surgery or thrombolytic therapy. Not surprisingly, there is no randomized controlled trial evaluating these two treatments and the published guidelines offer no definitive solution with some indicating thrombolysis and others repeat surgery as the primary optimum treatment. This article is protected by copyright. All rights reserved.
    Journal of Thrombosis and Haemostasis 06/2014; 12(8). DOI:10.1111/jth.12640
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    ABSTRACT: Background: Even though the acetylation of platelet cyclooxygenase (COX)-1 at serine-529 is the direct mechanism of action of low-dose aspirin, its antiplatelet effect has been characterized using indirect indexes of COX-1 activity. Objectives: We performed a clinical study with enteric-coated low-dose aspirin (EC-aspirin), in healthy subjects, to evaluate the effects on the extent and duration of platelet COX-1 acetylation, using a novel proteomic strategy for absolute protein quantification (termed AQUA), as compared with traditional pharmacokinetic and pharmacodynamic parameters. Subjects and methods: In a phase I, single-arm, open-label study of EC aspirin (100 mg day(-1)) administered to 24 healthy subjects, we compared, over a 24 h-period on day 1 and 7, % platelet acetylated COX-1 (AceCOX-1) with traditional pharmacokinetic and pharmacodynamics [i.e. serum thromboxane (TX) B-2, platelet function by monitoring CEPI(collagen/epinephrine) closure time (CT) using whole-blood PFA-100 and urinary excretion of 11-dehydro-TXB2] parameters. Results: Acetylation of platelet COX-1 was measurable before detection of aspirin levels in the systemic circulation and increased in a cumulative fashion upon repeated dosing. After the last dose of EC-aspirin, %AceCOX-1, serum TXB2 and CEPI-CT values were maximally and persistently modified throughout 24 h; they averaged 76 +/- 2%, 99.0 +/- 0.4% and 271 +/- 5 s, respectively. EC-aspirin caused 75% reduction in urinary 11-dehydro-TXB2 excretion. After chronic dosing with aspirin, the pharmacokinetics of acetylsalicylic acid was completely dissociated from pharmacodynamics. Conclusions: The demonstrated feasibility of quantifying the extent and duration of platelet COX-1 acetylation will allow characterizing the genetic, pharmacokinetic and pharmacodynamic determinants of the inter-individual variability in the antiplatelet response to low-dose aspirin as well as identifying extra-platelet sites of drug action.
    Journal of Thrombosis and Haemostasis 06/2014; 12(8). DOI:10.1111/jth.12637