Pharmacotherapy of Thromboembolism

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 25 February 2025 | Viewed by 7821

Special Issue Editors


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Guest Editor
1. Department of Internal Medicine I., Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, 03659 Martin, Slovakia
2. Division of acute and interventional cardiology, Department of Cardiology and Angiology II, Mid-Slovakian Institiute of Heart and Vessel Diseases (SÚSCCH) in Banská Bystrica, Slovakia
Interests: antithrombotic therapy; direct oral anticoagulants; laboratory monitoring of antithrombotic therapy; factors influencing the efficacy of antithrombotic therapy; stent thrombosis

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Guest Editor
Department of Internal Medicine I, Jesseniuss Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
Interests: direct oral anticoagulants; gastroprotection and antithrombotic therapy; bleeding on antithrombotic agents; factors influencing the efficacy of antithrombotic therapy

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Guest Editor
Department of Internal Medicine I, Jesseniuss Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
Interests: type 2 diabetes and thromboembolism; antithrombotic therapy in diabetic patients; direct oral anticoagulants; hypoglycemia

Special Issue Information

Dear Colleagues,

Thromboembolism (arterial and venous) is still an emergency clinical situation with high mortality and postevent morbidity. Moreover, the number of patients at risk for antithrombotic therapy-related complications who require long-term anticoagulation is increasing. Long-term antithrombotic therapy in patients with chronic diseases, elderly and frail patients, patients with cancer-related thromboembolism, or patients with the need for chronic anticoagulation who undergo vascular interventions could be problematic. Currently, the long-term pharmacotherapy of thromboembolism remains challenging and needs further research.

In addition, with the growing complexity of interventional procedures, the risk of future thrombotic complications increases. Antithrombotic therapy is crucial to prevent or to treat these complications. The role of modern antiplatelet agents in the prevention of thrombotic target lesion failure is being questioned and widely studied, but still with conflicting results, not allowing any final recommendations.

Finally, several novel antithrombotic agents, namely activated factor XI inhibitors, platelet glycoprotein VI antagonists, PAR4 antagonists, and PI3K inhibitors, are being either intensively studied, or introduced to phase II or III clinical testing. These novel agents could improve the efficacy and/or safety of long-term anticoagulation in future and require our attention.

This Special Issue has the aim to summarize the state-of-the-art drug discovery and drug design, and the latest findings in the field of long-term antithrombotic therapy, management of antithrombotic therapy in challenging clinical situations, and antithrombotic strategies in acute thrombotic complications during invasive vascular procedures. Original articles and reviews are welcomed for publication in this Special Issue.

Some of the questions that could tackle the Special Issue theme include, but are not limited to, the following:  

  • Activated factor XI inhibitors as an anti-thrombotica and anticoagulant agent in treatment of thromboembolism.
  • Synthesis, biological evaluation and molecular modeling studies of different platelet glycoprotein VI antagonists.
  • Small molecules in the field of antiplatelet agents with Protease activated receptor 4 (PAR4) antagonistic mechanism.
  • Current progress of using PI3K inhibitors in therapy.
  • Safety of long-term anticoagulant therapy use.
  • Drug-drug interactions of anticoagulants with different therapeutics.

Dr. Matej Samoš
Dr. Tomáš Bolek
Prof. Dr. Marián Mokáň
Guest Editors

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Keywords

  • activated factor XI inhibitors
  • platelet glycoprotein VI antagonists
  • PAR4 antagonists
  • PI3K inhibitorslong-term anticoagulation
  • antiplatelet therapy
  • novel antithrombotic drugs
  • anticoagulation-related bleeding
  • post-vascular procedure-related thrombosis

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Published Papers (4 papers)

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Research

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20 pages, 2804 KiB  
Article
A Descriptive Analysis of Direct Oral Anticoagulant Drugs Dosing Errors Based on Spontaneous Reports from the EudraVigilance Database
by Claudiu Morgovan, Carmen Maximiliana Dobrea, Adriana Aurelia Chis, Anca Maria Juncan, Anca Maria Arseniu, Luca Liviu Rus, Felicia Gabriela Gligor, Simona Alexandrina Ardelean, Laurentiu Stoicescu, Steliana Ghibu and Adina Frum
Pharmaceuticals 2023, 16(3), 455; https://doi.org/10.3390/ph16030455 - 17 Mar 2023
Cited by 8 | Viewed by 2652
Abstract
Direct oral anticoagulant drugs (DOACs) interfere with the coagulation process, thus improving patient care for those who require anticoagulant treatment. This study presents a descriptive analysis of adverse reactions (ADRs) attributed to DOAC dosage errors (overdose, underdose, and improper dose). The analysis was [...] Read more.
Direct oral anticoagulant drugs (DOACs) interfere with the coagulation process, thus improving patient care for those who require anticoagulant treatment. This study presents a descriptive analysis of adverse reactions (ADRs) attributed to DOAC dosage errors (overdose, underdose, and improper dose). The analysis was performed based on the Individual Case Safety Reports from the EudraVigilance (EV) database. Results show that data reported for rivaroxaban, apixaban, edoxaban, and dabigatran are mostly regarding underdosing (51.56%) compared to overdosing (18.54%). The most dosage error reports were identified for rivaroxaban (54.02%), followed by apixaban (33.61%). Dabigatran and edoxaban had similar percentages (6.26% and 6.11%, respectively) regarding dosage error reports. Since coagulation issues can become life-threatening events, and factors such as advanced age and renal failure can influence the pharmacokinetics of drugs, the correct usage of DOACs is of utmost importance for the management and prevention of venous thromboembolism. Thus, the collaboration and the complementarity of knowledge of physicians and pharmacists may offer a reliable solution for DOAC dose management and improve patient care. Full article
(This article belongs to the Special Issue Pharmacotherapy of Thromboembolism)
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Review

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34 pages, 981 KiB  
Review
Evaluating Thromboprophylaxis Strategies for High-Risk Pregnancy: A Current Perspective
by Lucia Stančiaková, Kristína Brisudová, Ingrid Škorňová, Tomáš Bolek, Matej Samoš, Kamil Biringer, Ján Staško and Juraj Sokol
Pharmaceuticals 2024, 17(6), 773; https://doi.org/10.3390/ph17060773 - 13 Jun 2024
Cited by 3 | Viewed by 892
Abstract
Venous thromboembolism (VTE) represents one of the leading causes of death during pregnancy. The greatest risk for it is the presence of medical or family history of VTE, stillbirth, cesarean section and selected thrombophilia. Appropriate thromboprophylaxis has the potential to decrease the risk [...] Read more.
Venous thromboembolism (VTE) represents one of the leading causes of death during pregnancy. The greatest risk for it is the presence of medical or family history of VTE, stillbirth, cesarean section and selected thrombophilia. Appropriate thromboprophylaxis has the potential to decrease the risk of VTE in at-risk pregnant patients by 60–70%. Based on this, the authors reviewed the PubMed, Web of Science and Scopus databases to identify the possibilities of thromboprophylaxis in pregnant patients with a high risk of VTE. Moreover, they summarized its management in specific situations, such as cesarean delivery or neuraxial blockade. Currently, low-molecular-weight heparins (LMWH) are the preferred drugs for anticoagulant thromboprophylaxis in the course of pregnancy and postpartum due to easy administration and a lower rate of adverse events. Full article
(This article belongs to the Special Issue Pharmacotherapy of Thromboembolism)
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16 pages, 1340 KiB  
Review
The Anti-Thrombotic Effects of PCSK9 Inhibitors
by Martin Jozef Péč, Jakub Benko, Jakub Jurica, Monika Péčová, Marek Samec, Tatiana Hurtová, Tomáš Bolek, Peter Galajda, Martin Péč, Matej Samoš and Marián Mokáň
Pharmaceuticals 2023, 16(9), 1197; https://doi.org/10.3390/ph16091197 - 22 Aug 2023
Cited by 2 | Viewed by 2309
Abstract
Atherosclerosis is the primary process that underlies cardiovascular disease. The connection between LDL cholesterol and the formation of atherosclerotic plaques is established by solid evidence. PCSK9 inhibitors have proven to be a valuable and practical resource for lowering the LDL cholesterol of many [...] Read more.
Atherosclerosis is the primary process that underlies cardiovascular disease. The connection between LDL cholesterol and the formation of atherosclerotic plaques is established by solid evidence. PCSK9 inhibitors have proven to be a valuable and practical resource for lowering the LDL cholesterol of many patients in recent years. Their inhibitory effect on atherosclerosis progression seems to be driven not just by lipid metabolism modification but also by LDL-independent mechanisms. We review the effect of PCSK9 inhibitors on various mechanisms involving platelet activation, inflammation, endothelial dysfunction, and the resultant clot formation. The main effectors of PCSK9 activation of platelets are CD36 receptors, lipoprotein(a), oxidised LDL particles, tissue factor, and factor VIII. Many more molecules are under investigation, and this area of research is growing rapidly. Full article
(This article belongs to the Special Issue Pharmacotherapy of Thromboembolism)
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13 pages, 681 KiB  
Review
How to Treat Today? Oral and Facial Cancer-Associated Venous Thromboembolism
by Mária Janíčková, Tomáš Bolek, Lucia Stančiaková, Norbert Nagy, Marián Mokáň and Matej Samoš
Pharmaceuticals 2023, 16(7), 1011; https://doi.org/10.3390/ph16071011 - 17 Jul 2023
Viewed by 1180
Abstract
The exact incidence of cancer-associated venous thromboembolism (CA-VTE) in patients with oral and facial cancer (OFC) is not exactly known, and this risk is empirically considered to be low. However, this suggestion may result in disease underdiagnosis, prolong the initiation of adequate therapy, [...] Read more.
The exact incidence of cancer-associated venous thromboembolism (CA-VTE) in patients with oral and facial cancer (OFC) is not exactly known, and this risk is empirically considered to be low. However, this suggestion may result in disease underdiagnosis, prolong the initiation of adequate therapy, and consecutively increase CA-VTE-related morbidity and mortality. In addition, there might be specific clinical problems in the treatment of CA-VTE in patients with oral and facial cancer, such as swallowing difficulties, that might limit the possibilities of oral anticoagulation. Finally, there are limited data regarding the optimal treatment of CA-VTE in patients with oral and facial cancer, and this includes data on novel therapeutic strategies, including the use of direct oral anticoagulants. This article reviews current data on the optimal treatment strategy for CA-VTE in patients with OFC. Full article
(This article belongs to the Special Issue Pharmacotherapy of Thromboembolism)
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