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Akbalut C, Arisz R, Baaten C, Baildildinova G, Barakzie A, Bauersachs R, Ten Berg JM, van den Broek W, de Boer HC, Broker V, Buka R, Ten Cate H, Cate AT, De Luca C, De Simone I, Dignat-George F, Freson K, Gazzaniga G, van Gorp E, Habibi A, Henskens YMC, Iding AFJ, Khan A, Koenderink G, Konkoth A, Lacroix R, Lahiri T, Lam W, Lamerton R, Lorusso R, Luo Q, Maas C, McCarty OJT, van der Meijden P, Meijers J, Mohapatra A, Nevo N, Pallares Robles A, Poncelet P, Reinhardt C, Ruf W, Saraswat R, Schonichen C, Schutgens REG, Simioni P, Spada S, Spronk HMH, Tazhibayeva K, Thachil J, Vacik-Diaz R, Veninga A, Verhamme P, Visser C, Watson SP, Wenzel P, Willems R, Willers A, Zhang P, Zifkos K, van Zonneveld AJ. Blood coagulation and beyond: Position paper from the Fourth Maastricht Consensus Conference on Thrombosis. Thromb Haemost 2023. [PMID: 36913975 PMCID: PMC10365887 DOI: 10.1055/a-2052-9175] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The 4th Maastricht Consensus Conference on Thrombosis (MCCT), included the following themes: Theme 1: The "coagulome" as a critical driver of cardiovascular disease Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbiome status. Virus infections associated-coagulopathies perturb the hemostatic balance resulting in thrombosis and/or bleeding. Theme 3: How to limit bleeding risks: insights from translational studies This theme included state of the art methodology for exploring the contribution of genetic determinants of a bleeding diathesis; determination of polymorphisms in genes that control the rate of metabolism by the liver of P2Y12 inhibitors, to improve safety of antithrombotic therapy. Novel reversal agents for direct oral anticoagulants are discussed. Theme 4: Hemostasis in extracorporeal systems: how to utilize ex vivo models? Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularised organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation (ECMO) associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management Plenary presentations addressed controversial areas, ie thrombophilia testing, thrombosis risk assessment in hemophilia, novel antiplatelet strategies and clinically tested factor XI(a) inhibitors,both possibly with reduced bleeding risk. Finally, Covid-19 associated coagulopathy is revisited.
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Affiliation(s)
- Cengiz Akbalut
- Biochemistry, Maastricht University Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | | | - Constance Baaten
- Maastricht University Medical Center, Maastricht, Netherlands.,Uniklinik RWTH Aachen, Aachen, Germany
| | | | | | - Rupert Bauersachs
- Department of Vascular Medicine, Cardioangiologisches Centrum Bethanien, Frankfurt, Germany.,Center for Vascular Research, Germany
| | | | | | - Hetty C de Boer
- Dept. of Nephrology, Leiden University Medical Center, Leiden, Netherlands
| | - Vanessa Broker
- Biochemistry, Maastricht University, Maastricht, Netherlands.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Richard Buka
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Hugo Ten Cate
- Thrombosis Expert Center and departments of Internal medicine and Biochemistry, Maastricht University Medical Centre+, Maastricht, Netherlands.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arina Ten Cate
- UNS 50/box 8, University Medical Center, Maastricht, Netherlands
| | - Ciro De Luca
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Ilaria De Simone
- Biochemistry, Maastricht University, Maastricht, Netherlands.,Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom of Great Britain and Northern Ireland
| | - Françoise Dignat-George
- INSERM, VRCM, UMR-S1076,, Aix-Marseille University, UFR de Pharmacie, Marseille, France, Marseille, France
| | - Kathleen Freson
- Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Giulia Gazzaniga
- Cardiothoracic Surgery, Maastricht University Medical Centre+, Maastricht, Netherlands
| | | | - Anxhela Habibi
- Biochemistry, Maastricht University, Maastricht, Netherlands
| | | | - Aaron F J Iding
- Biochemistry, Maastricht University Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Abdullah Khan
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland.,MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Gijsje Koenderink
- Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, Netherlands
| | - Akhil Konkoth
- Biochemistry, Maastricht University, Maastricht, Netherlands.,C2VN Inserm, Aix-Marseille Universite, Marseille, France
| | - Romaric Lacroix
- Inserm UMR-S1076, UFR de Pharmacie, Aix Marseille Université, Marseille, France
| | - Trisha Lahiri
- Center for Thrombosis and Hemostasis, Johannes Gutenberg Universität Mainz, Mainz, Germany.,C2VN Inserm, Aix-Marseille Universite, Marseille, France
| | - Wilbur Lam
- Emory University, Atlanta, United States
| | - Rachel Lamerton
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Roberto Lorusso
- Cardiovascular Centre, Maastricht University Medical Centre+, Maastricht, Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Qi Luo
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Biochemistry, Maastricht University, Maastricht, Netherlands
| | - Coen Maas
- University Medical Center Utrecht, Clinical Chemistry and Hematology, Utrecht University, Utrecht, Netherlands
| | - Owen J T McCarty
- Biomedical Engineering, Oregon Health & Science University, Portland, United States
| | | | | | - Adarsh Mohapatra
- Biochemistry, Maastricht University, Maastricht, Netherlands.,IMCAR, University Hospital Aachen, Aachen, Germany.,C2VN Inserm, Aix-Marseille Universite, Marseille, France
| | - Neta Nevo
- Immunology, Weizmann Institute of Science, Rehovot, Israel.,Immunology, Technion Israel Institute of Technology, Haifa, Israel
| | - Alejandro Pallares Robles
- Department of Biochemistry, Maastricht University Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.,Center of Thrombosis and Hemostasis, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Christoph Reinhardt
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Mainz, Germany
| | - Wolfram Ruf
- Center for Thrombosis and Hemostasis, Johannes Gutenberg Universitat Universitatsmedizin, Mainz, Germany
| | - Ronald Saraswat
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,C2VN Inserm, Aix-Marseille Universite, Marseille, France
| | - Claudia Schonichen
- Biochemistry, Maastricht University, Maastricht, Netherlands.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Paolo Simioni
- Dep of Cardiological, Thoracic and Vascular Sciences, University of Padua ; 2nd Chair of Internal Medicine, Padua, Italy
| | - Stefano Spada
- Biochemistry, Maastricht University, Maastricht, Netherlands.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Henri M H Spronk
- Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands.,Thrombosis Expert Center, Maastricht University Medical Centre+, Maastricht, Netherlands
| | | | - Jecko Thachil
- Haematology, Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Rocio Vacik-Diaz
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,C2VN Inserm, Aix-Marseille Universite, Marseille, France
| | - Alicia Veninga
- Biochemistry, Maastricht University, Maastricht, Netherlands
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, KULeuven, Leuven, Belgium
| | - Chantal Visser
- Hematology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Steve P Watson
- University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Philip Wenzel
- Zentrum für Kardiologie - Centrum für Thrombose und Hämostase, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Ruth Willems
- Biochemistry and Internal Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands.,Research, Synapse Research Institute, Maastricht, Netherlands
| | - Anne Willers
- Cardiothoracic Surgery, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Pengyu Zhang
- Biochemistry, Maastricht University, Maastricht, Netherlands.,ISAS Leibniz Institute for Analytical Sciences, Dortmund, Germany
| | - Konstantinos Zifkos
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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