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  1. Article ; Online: The warfarin renaissance.

    Pengo, Vittorio

    Internal and emergency medicine

    2024  

    Language English
    Publishing date 2024-02-27
    Publishing country Italy
    Document type Letter
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-024-03564-0
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  2. Article ; Online: Interaction between Antiphospholipid Antibodies and Protein C Anticoagulant Pathway: A Narrative Review.

    Pengo, Vittorio

    Seminars in thrombosis and hemostasis

    2022  Volume 48, Issue 8, Page(s) 971–977

    Abstract: Thrombotic antiphospholipid syndrome (APS) is a condition in which thrombosis in venous, arterial, and/or small vessels is ascribed to the presence of antiphospholipid antibodies (aPL). Among the various proposed pathogenic theories to explain thrombotic ...

    Abstract Thrombotic antiphospholipid syndrome (APS) is a condition in which thrombosis in venous, arterial, and/or small vessels is ascribed to the presence of antiphospholipid antibodies (aPL). Among the various proposed pathogenic theories to explain thrombotic APS, those involving the interaction between aPL and the protein C system have gained much consensus. Indeed, robust data show an acquired activated protein C resistance (APC-R) in these patients. The role of aPL in this impairment is clear, but the mechanism of action is uncertain, as the type of aPL and to what extent aPL are involved remains a gray area. Lupus anticoagulant (LA) is often associated with APC-R, but antibodies generating LA comprise those directed to β2-glycoprotein I and antiphosphatidylserine/prothrombin. Moreover, the induction of APC-R by aPL requires the presence of phospholipids and is suppressed by the presence of an excess of phospholipids. How phospholipids exposed on the cell membranes work in the system in vivo is unknown. Interestingly, acquired APC-R due to aPL might explain the clinical phenotypes of thrombotic APS. Indeed, the literature reports cases of both venous and arterial thromboembolism as well as skin necrosis, the latter observed in the severe form of protein C deficiency and in catastrophic APS.
    MeSH term(s) Humans ; Protein C ; Anticoagulants ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Lupus Coagulation Inhibitor ; Thrombosis/complications ; Phospholipids
    Chemical Substances Protein C ; Anticoagulants ; Antibodies, Antiphospholipid ; Lupus Coagulation Inhibitor ; Phospholipids
    Language English
    Publishing date 2022-01-12
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 196901-8
    ISSN 1098-9064 ; 0094-6176
    ISSN (online) 1098-9064
    ISSN 0094-6176
    DOI 10.1055/s-0041-1742083
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  3. Article ; Online: Additional laboratory tests to improve on the diagnosis of antiphospholipid syndrome: Response from Pengo.

    Pengo, Vittorio

    Journal of thrombosis and haemostasis : JTH

    2021  Volume 18, Issue 11, Page(s) 3118–3119

    MeSH term(s) Antibodies, Antiphospholipid ; Antiphospholipid Syndrome/diagnosis ; Clinical Laboratory Techniques ; Humans ; Lupus Coagulation Inhibitor
    Chemical Substances Antibodies, Antiphospholipid ; Lupus Coagulation Inhibitor
    Language English
    Publishing date 2021-01-18
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.15026
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  4. Article ; Online: Viewpoint: Provoked thrombosis in antiphospholipid syndrome.

    Wahl, Denis / Pengo, Vittorio

    Rheumatology (Oxford, England)

    2024  Volume 63, Issue SI, Page(s) SI37–SI45

    Abstract: Unprovoked thrombosis (thrombosis occurring without an established environmental factor favouring the episode) is a classic feature of APS. In the general population, provoked venous thromboembolism (VTE) is clearly defined and has clinical and ... ...

    Abstract Unprovoked thrombosis (thrombosis occurring without an established environmental factor favouring the episode) is a classic feature of APS. In the general population, provoked venous thromboembolism (VTE) is clearly defined and has clinical and therapeutic differences compared with unprovoked VTE. Whether provoked VTE in the context of APS may lead to a limited treatment duration is not well established. Therefore, careful clinical and laboratory evaluation is needed to identify patients eligible for a limited duration of anticoagulation treatment after provoked VTE. Given the uncertainties of available data, the risks and benefits of treatment decisions should be clearly explained. Decisions should be shared by both the patient and physician. Cardiovascular risk factors are common in patients with APS with arterial thrombosis. There are insufficient data suggesting that cardiovascular risk factor control would allow the cessation of anticoagulation. In most instances, arterial thrombosis will require prolonged anticoagulants. A careful analysis of clinical characteristics and laboratory evaluation, particularly the aPL antibody profile, is needed to make decisions on a case-by-case basis.
    MeSH term(s) Humans ; Antiphospholipid Syndrome/complications ; Venous Thromboembolism/drug therapy ; beta 2-Glycoprotein I ; Thrombosis/etiology ; Anticoagulants/therapeutic use
    Chemical Substances beta 2-Glycoprotein I ; Anticoagulants
    Language English
    Publishing date 2024-02-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kead675
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  5. Article: Interaction between Antiphospholipid Antibodies and Protein C Anticoagulant Pathway: A Narrative Review

    Pengo, Vittorio

    Seminars in Thrombosis and Hemostasis

    (Celebrating 50 years of Seminars in Thrombosis and Hemostasis—Part I)

    2022  Volume 48, Issue 08, Page(s) 971–977

    Abstract: Thrombotic antiphospholipid syndrome (APS) is a condition in which thrombosis in venous, arterial, and/or small vessels is ascribed to the presence of antiphospholipid antibodies (aPL). Among the various proposed pathogenic theories to explain thrombotic ...

    Series title Celebrating 50 years of Seminars in Thrombosis and Hemostasis—Part I
    Abstract Thrombotic antiphospholipid syndrome (APS) is a condition in which thrombosis in venous, arterial, and/or small vessels is ascribed to the presence of antiphospholipid antibodies (aPL). Among the various proposed pathogenic theories to explain thrombotic APS, those involving the interaction between aPL and the protein C system have gained much consensus. Indeed, robust data show an acquired activated protein C resistance (APC-R) in these patients. The role of aPL in this impairment is clear, but the mechanism of action is uncertain, as the type of aPL and to what extent aPL are involved remains a gray area. Lupus anticoagulant (LA) is often associated with APC-R, but antibodies generating LA comprise those directed to β2-glycoprotein I and antiphosphatidylserine/prothrombin. Moreover, the induction of APC-R by aPL requires the presence of phospholipids and is suppressed by the presence of an excess of phospholipids. How phospholipids exposed on the cell membranes work in the system in vivo is unknown. Interestingly, acquired APC-R due to aPL might explain the clinical phenotypes of thrombotic APS. Indeed, the literature reports cases of both venous and arterial thromboembolism as well as skin necrosis, the latter observed in the severe form of protein C deficiency and in catastrophic APS.
    Keywords protein C ; resistance ; phospholipid ; syndrome ; antibodies ; thrombosis ; lupus anticoagulant
    Language English
    Publishing date 2022-01-12
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 196901-8
    ISSN 1098-9064 ; 0094-6176
    ISSN (online) 1098-9064
    ISSN 0094-6176
    DOI 10.1055/s-0041-1742083
    Database Thieme publisher's database

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  6. Article ; Online: Additional laboratory tests to improve on the diagnosis of antiphospholipid syndrome.

    Pengo, Vittorio

    Journal of thrombosis and haemostasis : JTH

    2020  Volume 18, Issue 8, Page(s) 1846–1848

    Abstract: Whether additional tests to improve on the diagnosis of antiphospholipid syndrome are useful is a matter of debate. New tests exploring the presence of antiphospholipid antibodies are now available and comprise subgroups of antibodies directed to β2- ... ...

    Abstract Whether additional tests to improve on the diagnosis of antiphospholipid syndrome are useful is a matter of debate. New tests exploring the presence of antiphospholipid antibodies are now available and comprise subgroups of antibodies directed to β2-glycoprotein I, namely anti-Domain 1 and anti-Domain 4/5, and anti-phosphatidylserine/prothrombin antibodies. The aim of this article is to discuss in a forum with the scientific community on the possible utility of additional test for the diagnosis of antiphospholipid syndrome, especially in incomplete antiphospholipid antibody profiles.
    MeSH term(s) Antibodies, Antiphospholipid ; Antiphospholipid Syndrome/diagnosis ; Clinical Laboratory Techniques ; Humans ; Lupus Coagulation Inhibitor ; Prothrombin ; beta 2-Glycoprotein I
    Chemical Substances Antibodies, Antiphospholipid ; Lupus Coagulation Inhibitor ; beta 2-Glycoprotein I ; Prothrombin (9001-26-7)
    Language English
    Publishing date 2020-06-25
    Publishing country England
    Document type Letter
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.14896
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  7. Article ; Online: Oral anticoagulants in thrombotic antiphospholipid syndrome: Leave the old road for a new trail?

    Pengo, Vittorio

    European journal of internal medicine

    2020  Volume 79, Page(s) 29–30

    MeSH term(s) Anticoagulants/therapeutic use ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/drug therapy ; Fibrinolytic Agents ; Humans ; Thrombosis/drug therapy ; Vitamin K
    Chemical Substances Anticoagulants ; Fibrinolytic Agents ; Vitamin K (12001-79-5)
    Language English
    Publishing date 2020-08-04
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2020.07.020
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  8. Article: The influence of factor V Leiden and G20210A prothrombin mutation on the presence of residual vein obstruction after idiopathic deep-vein thrombosis of the lower limbs.

    Cosmi, Benilde / Legnani, Cristina / Pengo, Vittorio / Ghirarduzzi, Angelo / Testa, Sophie / Poli, Daniela / Prisco, Domenico / Tripodi, Armando / Palareti, Gualtiero

    Thrombosis and haemostasis

    2013  Volume 109, Issue 3, Page(s) 510–516

    Abstract: It was our aim to assess whether factor V Leiden (FVL) and G20210A prothrombin (FII) mutation are ...

    Abstract It was our aim to assess whether factor V Leiden (FVL) and G20210A prothrombin (FII) mutation are associated with the presence of residual vein obstruction (RVO) after a standard course of anticoagulation for a first episode of idiopathic proximal deep-vein thrombosis (DVT) of the lower limbs, with or without symptomatic pulmonary embolism (PE). Patients were enrolled in two prospective multicentre studies: PROLONG and PROLONG II. RVO was detected by compression ultrasonography according to the method of Prandoni on the day of anticoagulation withdrawal. Patients were also screened for FVL and FII mutation. The presence of FVL and/or FII mutation was determined in 872/963 (90.5%) patients, in 753 of whom RVO was assessed. FVL was significantly less frequent among subjects with isolated PE (7/176:4%) than among patients with either DVT and PE (15/133:11.3%; p=0.0018) or isolated DVT (89/563:15.8%; p<0.0001), confirming the FVL paradox. The rate of FII mutation was similar among patients with isolated PE (11/176:6.2%) and patients with either DVT and PE (12/133:9%) or isolated DVT (52/563:9.2%). FVL and FII mutation were not significantly associated with RVO at the multivariate analysis in all patients, although data suggest that FVL and FII mutation may have a differential effect on RVO in the subgroups of patients with DVT and DVT plus PE patients. Male sex and isolated DVT were significantly associated with RVO in all patients. In conclusion, male sex and isolated DVT are associated with RVO, while FVL and FII mutations are not significantly associated with RVO in this study.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants/therapeutic use ; Factor V/genetics ; Factor V/metabolism ; Female ; Humans ; Lower Extremity/pathology ; Male ; Middle Aged ; Mutation ; Prospective Studies ; Prothrombin/genetics ; Prothrombin/metabolism ; Pulmonary Embolism/complications ; Thrombophilia/blood ; Thrombophilia/complications ; Thrombophilia/genetics ; Ultrasonography/methods ; Vascular Diseases/blood ; Vascular Diseases/complications ; Vascular Diseases/genetics ; Venous Thrombosis/blood ; Venous Thrombosis/complications ; Venous Thrombosis/genetics ; Young Adult
    Chemical Substances Anticoagulants ; factor V Leiden ; Factor V (9001-24-5) ; Prothrombin (9001-26-7)
    Language English
    Publishing date 2013-03
    Publishing country Germany
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial
    ZDB-ID 518294-3
    ISSN 0340-6245
    ISSN 0340-6245
    DOI 10.1160/TH12-01-0041
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  9. Article ; Online: Commentary.

    Pengo, Vittorio

    Clinical chemistry

    2018  Volume 64, Issue 5, Page(s) 781

    MeSH term(s) Adult ; Female ; Humans ; Pregnancy
    Language English
    Publishing date 2018-04-24
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 80102-1
    ISSN 1530-8561 ; 0009-9147
    ISSN (online) 1530-8561
    ISSN 0009-9147
    DOI 10.1373/clinchem.2017.282053
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  10. Article ; Online: Antiphospholipid Syndrome in Patients with Venous Thromboembolism.

    Pengo, Vittorio / Denas, Gentian

    Seminars in thrombosis and hemostasis

    2022  Volume 49, Issue 8, Page(s) 833–839

    Abstract: Unprovoked (or provoked by mild risk factors) venous thromboembolism (VTE) in young patients, VTE in uncommon sites, or cases of unexplained VTE recurrence may be positive for antiphospholipid antibodies (aPL) and thus may be diagnosed with ... ...

    Abstract Unprovoked (or provoked by mild risk factors) venous thromboembolism (VTE) in young patients, VTE in uncommon sites, or cases of unexplained VTE recurrence may be positive for antiphospholipid antibodies (aPL) and thus may be diagnosed with antiphospholipid syndrome (APS). The evaluation of aPL is standardized using immunological tests for anticardiolipin and anti-β2-glycoprotein I. The determination of functional antibodies (lupus anticoagulant) is less standardized, especially in patients on anticoagulant treatment. Patients positive for all the three tests are at high risk of recurrence, which, in turn, might lead to chronic obstruction of pulmonary vessels (chronic thromboembolic pulmonary hypertension). Randomized clinical trials have shown that triple-positive patients should be treated with vitamin K antagonists maintaining an international normalized ratio between 2 and 3. Whether patients with VTE and incomplete aPL profile can be treated with direct oral anticoagulants should be further investigated.
    MeSH term(s) Humans ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/drug therapy ; Antiphospholipid Syndrome/diagnosis ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/etiology ; Antibodies, Antiphospholipid ; Anticoagulants/adverse effects ; Lupus Coagulation Inhibitor/therapeutic use
    Chemical Substances Antibodies, Antiphospholipid ; Anticoagulants ; Lupus Coagulation Inhibitor
    Language English
    Publishing date 2022-06-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 196901-8
    ISSN 1098-9064 ; 0094-6176
    ISSN (online) 1098-9064
    ISSN 0094-6176
    DOI 10.1055/s-0042-1749590
    Database MEDical Literature Analysis and Retrieval System OnLINE

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