CLOT Conversations – Détails, épisodes et analyse

Send us a text

In this episode of CLOT Conversations, we sit down with Dr. Marc Carrier to explore a groundbreaking study published in the New England Journal of Medicine on reduced-dose apixaban for cancer-associated venous thromboembolism (VTE). Dr. Carrier breaks down the study’s findings, which suggest that a lower dose of apixaban after six months of treatment is just as effective in preventing clot recurrence — and significantly safer in terms of bleeding risk. Tune in for expert insights on how this data could shift clinical practice and improve outcomes for patients living with cancer.

Reference:

Mahé I, Carrier M, Mayeur D, Chidiac J, Vicaut E, Falvo N, Sanchez O, Grange C, Monreal M, López-Núñez JJ, Otero-Candelera R. Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism. New England Journal of Medicine. 2025 Mar 29.

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

Drs. Mithoowani and Siegal discuss new expert guidance for managing severe bleeding in patients taking oral anticoagulants, including identifying those at risk, optimizing supportive measures, treating the source of bleeding, and administering reversal agents. It includes discussion of the algorithm for use at the point of care that helps identify patients at risk of adverse outcomes, optimize supportive measures, treat the source of bleeding, and administer anticoagulant reversal or hemostatic therapies.

Abstract: http://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2464-2887
Full text HTML: http://www.thieme-connect.com/products/ejournals/html/10.1055/a-2464-2887
Full text PDF: http://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-2464-2887.pdf 

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

 Dr Vicky Mai presented multiple times at the ISTH 2023. Dr Le Gal talks to her about the research that she presented and the implications. The first study that she presented was a systematic review with metaanalysis on thrombolysis in intermediate high and high risk PE. The second one was an abstract on a sub analysis of the PREDICTORS study which looked at the risk of recurrent VTE in patient who presented with a suspicion of recurrent VTE on anticagulation. And there's two projects on COPD exacerbation and pulmonary embolism. 

Join us on Twitter:

@thrombosiscan
@VickyMai
@grelegal

Visit www.thrombosiscanada.ca for more information and resources

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

Dr Abdulrehman interviews three researchers working in Canada who presented work at ISTH 2023 in Montreal. Dr Menal Huroy, reviews her poster on The Impact of GI Surgeries on peak plasma anti-Xa Direct Oral Anticoagulant levels, Dr Adam Suleman discusses his research on The Risk iof VTE in Primary CNS Lymphoma: A Systematic Review and Dr Ismail Raslan discussed his research, Anticoagulation Post-Pulmonary Endarterectomy: A Retrospective Cohort Study. Three quick interviews covered in 11 minutes!

Follow us on Twitter:
@thrombosiscan

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

Join us for an in-depth conversation with Dr Lucia Caiano and Dr Tzu-Fei Wang, two of the authors of a review exploring the potential role of statins in preventing post-thrombotic syndrome (PTS), a frequent long-term complication of deep vein thrombosis (DVT). They dive into their systematic review and meta-analysis, discussing the intriguing findings drawn from 1971 screened records. The interview reveals their insightful interpretations of data, including the possible 22% reduction of PTS incidence with statin use. Yet, they also acknowledge the limitations seen in randomized controlled trials (RCTs). The conversation offers an invaluable opportunity to better understand the challenges of PTS prevention, the promising role of statins, and the crucial need for larger RCTs to confirm these findings. Don't miss this chance to gain expert insights into this rapidly developing field of medical research.

Contact us on Twitter:
@ThrombosisCan
@TzufeiWang

Ref:

Caiano L, Drury T, Zahrai A, Wang TF, Siegal DM, Rodger MA, Fournier K, Delluc A. Role of statins in the prevention of post-thrombotic syndrome after a deep venous thrombosis event: a systematic review and meta-analysis. Journal of Thrombosis and Haemostasis. 2022 Dec 22.

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

In this episode of CLOT Conversations we interview Dr Saskia Middeldorp and Dr Hanke Wiegers, authors of the groundbreaking Highlow study. This open-label, multicenter, randomized controlled trial aimed to determine the optimal dose of low-molecular-weight heparin (LMWH) for pregnant and postpartum women with a history of venous thromboembolism (VTE). Discover the study's findings on the incidence of recurrent VTE, major bleeding, and death from any cause between the intermediate-dose (ID) and low-dose (LD) LMWH groups. The results may surprise you and highlight the need for individualized dosing strategies for pregnant and postpartum women to balance the risks and benefits of anticoagulant therapy. Don't miss this fascinating episode!

Dr Saskia Middeldorp is Professor of Medicine and Head of the Department of Internal Medicine of the Radboud University Medical Center in Nijmegen, The Netherlands. Prior to her transfer to Nijmegen in January 2021, she has been a professor of Medicine at Amsterdam University Medical Centers for over 10 years, leading the clinical thrombosis and haemostasis research lines of the Department of Vascular Medicine. Since January 2023, Saskia Middeldorp is one of the 4 Research Domain Leaders in the Radboudumc Research Institution for Medical Innovation.

Her present research focuses on several aspects of hereditary and acquired thrombophilia, women’s issues in thrombosis and haemostasis, and the clinical evaluation of new anticoagulants and antidotes.

Dr Hanke Wiegers is an MD, PhD student, at the department of vascular medicine at the Amsterdam UMC, location AMC. In June 2019 she started her PhD trajectory under the supervision of Prof. Dr. S. Middeldorp as supervisor and focuses particularly on women & thrombosis. On the 17th of March 2023 she will defend her PhD thesis entitled: “Progress in prevention and prediction of venous thromboembolism in women – focus on pregnancy and the postpartum period.”  Hanke Wiegers started as a gynecologist in training on the 1st of January 2023 

Bistervels, I. M., Buchmüller, A., Wiegers, H. M., Áinle, F. N., Tardy, B., Donnelly, J., ... & Zelis, M. (2022). Intermediate-dose versus low-dose low-molecular-weight heparin in pregnant and post-partum women with a history of venous thromboembolism (Highlow study): an open-label, multicentre, randomised, controlled trial. The Lancet, 400(10365), 1777-1787 

Follow us on Twitter:
@thrombosiscan
@MiddeldorpS

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

Don't miss our latest podcast interview with Dr Joseph Shaw and Dr Tzu-Fei Wang who discuss insights from their single-center retrospective cohort study, which included 264 patients with nonvalvular AF and Cancer undergoing 302 periprocedural interruptions. Learn about the primary endpoints, which were the 30-day risks of arterial thromboembolism and major bleeding, and the results that showed relatively low risk for these complications when patients were managed according to commonly applied perioperative management recommendations. Tune in now to gain valuable knowledge on this important topic.

Aziz, Joseph, et al. "Thrombotic and Bleeding Outcomes Following the Perioperative Interruption of Anticoagulation Among Patients with Non-Valvular Atrial Fibrillation and Active Cancer." Journal of Thrombosis and Haemostasis (2022).

Follow us on Twitter
Dr Shaw: @JRand083
Dr Wang: @TzufeiWang
@thrombosiscanada.ca

www.thrombosiscanada.ca

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

In this interview, two of the authors of the paper Direct oral anticoagulants vs vitamin-K antagonists in thrombotic antiphospholipid syndrome: meta-analysis of randomized controlled trials, Dr Jean Connors and Dr Benhood Bikdeli, provide listeners with an overview of their systematic review and meta-analysis that evaluated the efficacy and safety of direct oral anticoagulants (DOACs) compared to vitamin K antagonists (VKAs) in patients with thrombotic antiphospholipid syndrome. The authors searched through three databases (PubMed, EMBASE, and Cochrane Central Register of Controlled Trials) and found four eligible randomized controlled trials with a total of 472 patients. Our podcast guests discuss the results of the study and the clinical implications.  

About our guests:

Dr Jean M Connors: 
Jean M. Connors, MD is a hematology attending at Brigham and Women’s Hospital and Dana-Farber Cancer Institute; the Medical Director of the Anticoagulation Management Services, and the Hemostatic Antithrombotic Stewardship Program; and an Associate Professor of Medicine at Harvard Medical School.

 She received a medical degree from The Johns Hopkins University in Baltimore, completed her residency in internal medicine at Beth Israel Deaconess Medical Center in Boson, as well as fellowships in transfusion medicine and hematology & oncology from Brigham and Women’s Hospital.

Dr. Connors is an Associate Editor for the Journal of Thrombosis and Haemostasis and the Journal of the American College of Cardiology: Basic to Translational Science. She is a member of or holds a leadership role in many professional societies, including ASH and ISTH. She has participated in numerous clinical trials for patients with venous thrombosis in cancer, and anticoagulation questions in general.

Dr Benhood Bikdeli:
Behnood Bikdeli, MD, MS is a clinician-investigator, with training in cardiology and in vascular medicine who is particularly interested in thrombotic diseases. He is an Associate Physician in the Division of Cardiovascular Medicine at Brigham and Women’s Hospital, an Instructor in Medicine at Harvard Medical School, and an investigator at Yale Center for Outcomes Research and Evaluation (CORE). His research has been funded by the NIH, the American Heart Association, Brigham and Women’s Hospital and others.

Dr Bikdeli has coauthored over 180 publications, which have been published in journals including Lancet, JAMA, JAMA Internal Medicine, Circulation, Journal of the American College of Cardiology, the British Medical Journal, and others. Dr. Bikdeli was the lead author of two international consensus documents related to thrombosis in COVID-19, is the joint principal investigator of the INSPIRATION/ INSPIRATION-S randomized controlled trial, and is an Associate Editor for Thrombosis Research.

Ref:
Khairani, C. D., Bejjani, A., Piazza, G., Jimenez, D., Monreal, M., Chatterjee, S., ... & Bikdeli, B. (2022). Direct oral anticoagulants vs vitamin-K antagonists in thrombotic antiphospholipid syndrome: meta-analysis of randomized controlled trials. Journal of the American College of Cardiology.

Follow us on Twitter:
@thrombosiscan
@connors_md

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

Are you curious about how to improve the safety and effectiveness of anticoagulant prescriptions for hospitalized patients? Join us for an exclusive interview with two of the authors (Dr Maral Koolian and Pharmacist Ryan Kerzner ) of a groundbreaking study on anticoagulation stewardship program at the Montreal Jewish General Hospital. Our guests will share their findings on the success rate of recommendations made by a multidisciplinary team of physicians and pharmacists, as well as the most common types of adjustments made to prescriptions. Don't miss this opportunity to learn more about the potential benefits of these programs and the future research needed to fully understand their impact on patient outcomes. Download this episode today!

Koolian, M., Wiseman, D., Mantzanis, H., Kampouris, N., Kerzner, R. S., & Kahn, S. R. (2022). Anticoagulation stewardship: Descriptive analysis of a novel approach to appropriate anticoagulant prescription. Research and Practice in Thrombosis and Haemostasis, 6(6), e12758. 

Guest Biographies: 

Dr Maral Koolian is an Assistant Professor of Medicine and the Director of the Adult Thrombosis Medicine AFC program at McGill University. She is a member of the Division of General Internal Medicine and the Centre of Excellence in Thrombosis and Anticoagulation Care (CETAC) at the Jewish General Hospital. She earned her medical degree at McGill University, where she subsequently completed post-graduate subspecialty training in General Internal Medicine. She then completed a 1-year clinical thrombosis fellowship at the University of Ottawa, followed by an MSc in Quality Improvement and Patient Safety at the University of Toronto. Her main research focus is quality improvement principles as they apply to venous thromboembolic disease and anticoagulation management. 

Ryan Kerzner graduated with a Bachelor of Pharmacy and a Masters in hospital pharmacy from the Université de Montréal. He has been a pharmacist at the Jewish General Hospital in Montreal since 2008. He is one of the co-founders of the hospital's Antimicrobial Stewardship programs, in which he is still actively involved. He also works in Internal Medicine where he developed an interest in Thrombosis medicine. He officially joined the hospital's CETAC team in 2019, which is the Centre of Excellence in Thrombosis & Anticoagulation Care. In CETAC, with Dr Koolian and 2 other thrombosis pharmacists, he was involved in the development an Anticoagulation Stewardship Program. 

Follow us on Twitter
@thrombosiscan
@MKoolian
@Pharmacist_MTL

Check out the resources on https://thrombosiscanada.ca

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Send us a text

In this episode we interview two of the authors of a recent paper, Diagnosis and management of severe congenital protein C deficiency (SCPCD): Communication from the SSC of the ISTH, Dr Maha Othman and Dr Leonardo Brandao on this paper from the Journal of Thrombosis and Haemostasis. 2022;20:1735–1743.

Severe congenital protein C deficiency (SCPCD) is rare and there is currently substantial variation in the management of this condition. A joint project by three Scientific and Standardization Committees of the ISTH was developed to review the current evidence and help guide on diagnosis and management of SCPCD.

About our guests:
Dr. Maha Othman is a clinical pathologist/hematologist with specialized training in haemostasis laboratory testing and molecular genetics of bleeding disorders. She obtained her medical degree and MSc in Clinical Pathology in Mansoura University in Egypt. She then completed her PhD in Pathology from Southampton University, UK. After this, she pursued post-doctoral research training in molecular genetics of hemophilia and von Willebrand disease with Dr. David Lillicrap, at Queen’s University, Canada. Dr. Othman is currently a full Professor at the School of Medicine, Queen’s University and at St Lawrence College, Kingston, Ontario. Her research interests include the clinical and molecular aspects of von Willebrand disease and platelet disorders particularly PT-VWD, and thromboelastography assessment of coagulopathies in women, pregnancy and cancer. She has more than 100 research papers and her research is recognized internationally. She is an editor for Seminars in Thrombosis and Haemostasis and Research and Practice in Thrombosis and Haemostasis Journals. She is a reviewer for a number of Haemostasis journals and a member of several scientific organizing committees on women’s health, and advisory boards for international haemostasis conferences. She is the previous Chairman of the Scientific and Standardization Committee (SSC) on Women’s Health Issues in Thrombosis and Haemostasis of the ISTH and currently CO-Chair on the SSC for DIC. She is a passionate educator and mentor and an advocate for rare bleeding disorders and bleeding and clotting disorders in women.

Dr. Leonardo Brandão  is a native Brazilian who joined the staff at The Hospital for Sick Children in 2004. Since 2019, he has been the Thrombosis Program director. He obtained his medical degree at the University of São Paulo (USP) School of Medicine (FMUSP) before moving to North America, where he completed his post-graduate training (Paediatrics Residency at Emory University, Atlanta/GA, Paediatric Haematology/Oncology fellowship at St. Jude Children's Research Hospital, Memphis/TN, and a second fellowship in Paediatric Coagulation at Weill Cornell University, New York/NY). After finishing his training, he moved to Canada to focus on the field of paediatric thrombosis at SickKids. 

He is the past-chair of the thrombosis committee for the Canadian Pediatric Thrombosis Hemostasis Network (CPTHN), past-Canadian representative-elect for the Hemostasis and Thrombosis Research Society (HTRS), past-member of the first paediatric venous thromboembolism panel for the American Society of Hematology (ASH), past-co-chair of the paediatric thrombosis subcommittee for the International Society on Thrombosis and Hemostasis (ISTH), and a member of Thrombosis Canada.

Links:

Support the show

https://thrombosiscanada.ca

Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada