October 2022: World Thrombosis Day

by Donna Castellone, MS, MT (ASCP) SH • September 28, 2022



The logo for WTD was designed by a patient: the red represents the artery, the blue represents the vein and the clot is represented by the white circle.


The interpretations below are provided by Donna Castellone, MS, MT (ASCP) SH for Aniara Diagnostica.


WTD has been awarded the Silver Anvil award for 2022 in Global Communications

World Thrombosis Day 2022 Global Webinar: Wednesday October 12, 2022 11am US EST: “How to Support VTE Risk Assessment Across Global Healthcare Systems”

Pre-registration: https://us02web.zoom.us/webinar/register/WN_XA_43FJeRNu9kbmyztNR5A


HOW DO YOU SAY THROMBOSIS AROUND THE GLOBE


The mission of World Thrombosis Day is to increase global awareness of thrombosis. It's goal is to reduce death and disability by highlighting causes and risks as well as signs and symptoms. The World Health Assembly's global target is to reduce premature deaths by 25% by 2025 in non-communicable diseases. Addressing thrombosis including atrial fibrillation and VTE are targets for this goal.



Summary

The incidence of thrombosis occurs in 1:in 4 people. In the US up to 900,000 people will experience a blood clot of those 100,000 will not survive. This exceeds the total deaths that occur from AIDS, breast cancer and motor vehicle accidents combined. When looking at rates that occur across income levels and in different regions the incidence of thrombosis is similar, with annual incidence rates ranging from 0.75 to 2.69 per 1000 individuals in the population. This incidence increases to between 2 and 7 per 1000 among those aged ≥ 70 years. Although the incidence is lower in individuals of Chinese and Korean ethnicity, their disease burden is not low, because of population aging. VTE that was associated with hospitalization was the leading cause of disability-adjusted life-years (DALYs) lost in low-income and middle-income countries, and the second most common cause in high-income countries. This exceeds the number of DALYs lost than nosocomial pneumonia, catheter-related bloodstream infections, and adverse drug events.



QUOTES FROM PATIENTS AROUND THE GLOBE:

- Thrombosis is a deadly disease. and it is a great benefit to us that there are organizations trying to aware everyone about this disease.
- Proper treatment is necessary to fight thrombosis and for proper treatment to take place, proper tests are needed.
- We should avail ourselves of this opportunity to educate ourselves about this life-threatening disease called thrombosis.
- Let us all come forward to help the world health organization in its mission to create awareness about thrombosis among everybody.
- If it were not for the celebration of the World Thrombosis Day, many people in many sectors of the society would still be uneducated and unaware of this disease.
- It is always advisable to take proper tests and keep yourself updated about your health so that in case of any discrepancies, proper treatment can be provided.
- On this World Thrombosis Day, we urge you to spread the word about thrombosis to at least one person you know.
- Spread the word about Thrombosis and help us save lives.
- We are thankful to all the health organizations for raising awareness about thrombosis all over the world.
- World Thrombosis day is a reminder to us to stay aware of the disease and to pass on the knowledge about this disease to other people as well.
- Thrombosis is one of the reasons behind the occurring of cardiac arrests and so we should be very aware of it.
- There are many procedures involved in the treatment of thrombosis and so it is not that thrombosis is incurable.



The Ten common symptoms of thrombosis:

Know Thrombosis: A Global Priority
It is important to understand your risk by knowing the signs and symptoms of thrombosis. Early diagnosis and treatment can often lead to recovery, but long-term complications, such as post-thrombotic syndrome and chronic thromboembolic pulmonary hypertension may occur.

  1. Swelling in legs and arms without injury that is not palpable and slight by touch.
  2. Warmness and Discolored Skin. Skin can be hot to the touch ànd would radiate from the swollen part. Skin may appear blueish or reddish.
  3. Weakness and Pain can be triggered by PE, strokes, MI or DVT. It may occur in the jaw, back, shoulder or arm.
  4. Stroke accompanied by other signs, such as difficulty walking, lightheadedness, vision issues, dizziness, and headaches. You can check for a stroke with F.A.S.T, which stands for:
    • Face: Check for one side of the face drooping
    • Arms: Determine whether you can lift and keep up the arms
    • Speech: Check for strange or slurred speech
    • Time: These symptoms tend to occur suddenly
  5. Tenderness in the affected area however it is difficult to diagnosis thrombosis on this symptom.
  6. Numbness occurs when blood clots place increased pressure on nerves.
  7. Lung Issues and Pulmonary Embolism: Thrombosis in the lungs tends to occur suddenly.
  8. Rapid breathing: Happens when the clot breaks off from the site of origin and travels to the lungs. This impedes blood flow to the lung.
  9. Chest Pain: If the clot migrates to the lung it may cause inflammation of the lung tissue resulting in sharp chest pain. This increases with heavy breathing and coughing.
  10. Dizziness: This occurs early on when the clot is smaller.



Laboratory testing

Screening tests. PT and aPTT screens for a factor deficiency which depending on the factor will prolong the result due to decreased levels of factors. If aPTT testing is performed with a lupus sensitive reagent, which contains a lower concentration of phospholipids, the result may be prolonged and point to a lupus anticoagulant. This is a risk for thrombosis. If the PT or aPTT is shortened it can point to an increased fibrinogen or Factor VIII, which can also increase thrombosis risk.

D dimer looks at clot formation among other things. The utility of this test is a negative result which helps to rule out a clot. A positive result can mean several things including the presence of a clot. However, it can also point to infection, inflammation and myocardial infarction.

Specialty coagulation testing to determine thrombosis includes Protein C, Protein S, Antithrombin and Activated protein C Resistance testing. A few suggestions, start with activity based testing then move to antigen to distinquish between a qualitative and quantitative disorder. However, if a patient presents with a clot and is treated with anticoagulation, testing should not be performed as all test results will not be accurate. The patient needs to be treated, however testing should occur prior to anticoagulation or after being removed. However, genetic testing for Factor V Leiden, Prothrombin mutation, MTHFR as well as PAI/4G5G mutation can be performed.



Treatement

DVT and PE are serious, life-threatening conditions that require immediate medical attention. They are treated with anticoagulants in order to prevent or treat blood clots.

  • Anticoagulants (e.g., injectables such as heparin, enoxaparin, or low molecular weight heparin, or tablets such as apixaban, dabigatran and rivaroxaban, edaxaban and warfarin)
  • Mechanical devices (e.g., compression stockings which may decrease your risk of long term problems that can be caused from having clots or a special filter placed in a vein)
  • Thrombolytic therapy (e.g., tissue plasminogen activator)



Conclusion:

It is so important to increase awareness to aid in the prevention of thrombosis and the impact that it has on patient's lives. Being able to reduce the burden of this can help improve the well being of patient's lives. Dedicating a day to this and educating the public is an important contribution in raising awareness and in the prevention of thrombosis.



References:

https://www.worldthrombosisday.org/

https://nationaltoday.com/world-thrombosis-day/

https://www.newlifeticket.com/conditions/10-common-symptoms-of-thrombosis/

https://www.worldthrombosisday.org/issue/thrombosis/



Resources:

To learn more about the global burden of the VTE, click here.

In October of 2014 the steering committee published "Thrombosis: a major contributor to the global disease burden," in the Journal of Thrombosis and Haemostasis (JTH). It reviewed 8000 citations and was published in the Journal of Thrombosis and Haemostasis, Thrombosis and Haemostasis Thrombosis Research, Seminars in Thrombosis and Hemostasis and Arteriosclerosis, Thrombosis and Vascular Biology. A commentary was also published in the esteemed Lancet.
Download the full article here.