What's Hot in Clots: April 2025

It’s that time of the year, again! I love the Spring—the weather becomes nicer, plus it’s the Persian New Year (March 20th). Sending y’all my best wishes. Here we go with summaries for this month:

Genes, protein S Levels, and thromboembolic events: It’s complicated!

Results from a study that used data from the UK Biobank and the US All of US cohorts suggests that certain forms of loss-of-function mutations of protein S and low plasma levels of protein S correlate with VTE; others less so.

Interestingly, researchers did not find a robust association with arterial thrombotic events such as MI or stroke. Read more.

Disparities in management and outcomes of PE: Better recognition is key to addressing them

A Scientific Statement from the American Heart Association covered information related to disparities by age, sex, gender, and race. Read more.

Low- vs full-intensity apixaban for cancer-associated VTE

In a double-blind, industry-sponsored trial, low-intensity apixaban was shown to be noninferior for effectiveness but resulted in fewer major or clinically relevant bleeding events. Read more here and the accompanying editorial here.

Catheter-associated fibrinolysis for PE: Could be done through superficial veins of the upper extremity

It is rare that I cover case reports, but this report was interesting about the future possibilities for catheter-based interventions through peripheral venous access. Read more.

DOACs vs no treatment in patients with AF and ICH: The tradeoffs continue

This randomized trial shows that use of DOACs after intracerebral hemorrhage (ICH) would still substantially reduce the risk of ischemic stroke (hazard ratio of 0.05!!), but at the cost of a 10-fold increase in the risk of subsequent ICH (hazard ratio: 10.89). Read more.

Behnood Bikdeli, MD, MS