🧵A brief thread on #CardiovascularSurgery and #PCI approaches for patients with heparin-induced thrombocytopenia (HIT) 🩸

Happy to share our review on this topic was recently published:

#hemetwitter #hemesky #classicalhematology
*not covering aHIT
1/8mp.pl/paim/issue/art… HIT follows a stereotyped temporal sequence based on the timeline of heparin exposure, thrombocytopenia, and the seroconversion and seroreversion of diagnostic assays

Understand the diagnostic assays to understand where you are in the natural history of HIT
2/

🧵A thread on HHT therapies 🩸

With the publication of the largest powered RCT of a systemic therapy for the 2nd most prevalent inherited bleeding disorder, let’s discuss our systemic therapies for bleeding in hereditary hemorrhagic telangiectasia (#HHT)⤵️

#hemetwitter
1/21

https://twitter.com/NEJM/status/1836519321511891415

Briefly, HHT
➡️affects 1/3800 ppl
➡️causes extensive mucocutaneous telangiectasias and visceral arteriovenous malformations (AVM)
➡️has pathogenic variants affecting TGFβ–BMP signaling
➡️leads to epistaxis, the primary sx affecting QoL

2/

🧵Thread on frontline caplacizumab and plasma exchange in TTP🚨

With advancing care for immune thrombotic thrombocytopenic purpura (iTTP), let’s discuss frontline caplacizumab (capla) and the future for therapeutic plasma exchange (TPE) ⤵️

#hemetwitter #TTP #caplacizumab
1/22 The early days of acute iTTP are of paramount importance: it appears to be the time when a majority of the morbidity (stroke, MI, etc) and mortality occurs

Prompt dx and tx prevents early (functionally-limiting?) end-organ damage for a disease with prolonging survivorship
2/

🧵Thread on the ANNEXA trials for reversing DOAC-related bleeds 🩸

As #DOAC (FXa inhibitors) have increasingly replaced VKAs, let’s discuss the development and study of their reversal agent #andexanet alfa, a recombinant inactive FXa that sequesters FXa inhibitor molecules
1/ In the ANNEXA-A and -R studies, andexanet alfa (AA) reduced anti-FXa activity and restored thrombin generation in healthy older volunteers

Maximal effect was noted within 2-5 min of bolus and sustained throughout the infusion

2/ nejm.org/doi/full/10.10…