iiinova — where your digital self keeps evolving

Reposted by Marc Carrier, MD

Thomas Reiser @tomreiser.bsky.social · 20/12/2025

In case you missed it and are wondering where @isth.org #ISTH2027 will be held: 🇨🇦 VANCOUVER 🇨🇦! Under the leadership of ACPC Chair @marccarriermd.bsky.social Mark your calendars already for June 26-30, 2027. Read more at: bit.ly/4iJznfy

064

Marc Carrier, MD @marccarriermd.bsky.social · 24/10/2025

🩸 Key takeaways from 2025 CanVECTOR meeting Even with standard LMWH thromboprophylaxis, fewer than half of ICU patients reach target anti-Xa levels. 🔹 Sub-prophylactic anti-Xa levels → ~3× higher risk of VTE Time to reconsider “standard dosing” in the ICU.

120

Marc Carrier, MD @marccarriermd.bsky.social · 23/10/2025

Are you the person everyone calls when anticoagulation gets complicated? Then you’ll fit right in at the Thrombosis Canada Annual Conference! Join colleagues from across the country to connect, learn, and debate complex #VTE and #Anticoagulation cases during our Morning Report. thrombosiscanada.ca

020

Reposted by Marc Carrier, MD

PSI Foundation @psifoundation.bsky.social · 14/10/2025

Drs. Kevin Durr, Alexandre Tran & Marc Carrier's @marccarriermd.bsky.social study on personalized risk stratification and reduction of venous thromboembolism among critically ill patients: www.psifoundation.org/funded-resea... #WorldThrombosisDay #ThrombosisResearch @ottawahospital.on.ca

psifoundation.org

Funded Research - PSI Foundation

List of projects funded by PSI Foundation.

021

Marc Carrier, MD @marccarriermd.bsky.social · 31/08/2025

#AQUATICtrial In chronic coronary syndrome pts at high 🫀atherothrombotic risk on long-term oral anticoagulation (OAC), adding ASA ↑ CV events (HR 1.53), death (HR 1.72) & major bleeding (HR 3.35) without benefit. OAC alone safer. Published in @nejm.org www.nejm.org/doi/full/10....

nejm.org

Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation | NEJM

The appropriate antithrombotic regimen for patients with chronic coronary syndrome who are at high atherothrombotic risk and receiving long-term oral anticoagulation remains unknown. We conducted a...

140

Marc Carrier, MD @marccarriermd.bsky.social · 17/08/2025

Radiotherapy may independently increase the risk of venous thromboembolism. 🩸⚡ This review in @rpth.bsky.social unpacks mechanisms, diagnostic challenges, and why thromboprophylaxis should be tailored rather than routine. 👉 doi.org/10.1016/j.rp... #Thrombosis #Oncology #CancerResearch

261

Marc Carrier, MD @marccarriermd.bsky.social · 14/08/2025

A new @thrombosiscan.bsky.social survey found that >50% of Canadian cancer patients have little or no awareness of cancer-associated thrombosis (CAT) — a major cause of death in cancer. 📊 Only 27% recalled being educated on CAT risks, yet most want more info! doi.org/10.1055/a-26...

031

Marc Carrier, MD @marccarriermd.bsky.social · 06/08/2025

☀️ A morning walk, fresh air, and great company – the perfect way to kick off a busy day at #ASHCRTI! 🏃‍♀️💬 Nothing like connecting with colleagues and faculty before diving into a full day of learning. Thanks to everyone who joined us this morning! 🙌 @ash.hematology.org

021

Marc Carrier, MD @marccarriermd.bsky.social · 23/07/2025

🧵1/ Diagnosing recurrent venous thromboembolism (VTE) is hard. The international, multicenter PREDICTORS study (n=723) shows that while clinical decision rules (CDRs) still help stratify risk, they’re less effective at ruling out recurrence without imaging. 🩺📉

121

Reposted by Marc Carrier, MD

RPTH @rpth.bsky.social · 16/07/2025

🆕 A new study protocol START aims to investigate the best strategies to reduce risk of thrombosis and thrombocytopenia in cancer patients. @marccarriermd.bsky.social 👉 Click here to read more about the study design and goals! www.rpthjournal.org/article/S247...

022

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

Implementation matters! A guideline-driven VTE prevention program (Vermont Model) led to ~60% of high-risk cancer patients receiving prophylactic anticoagulation—resulting in a 60% reduction in VTE and 56% reduction in death. #ISTH2025 #VTEprevention 🩸 @marycushmanmd.bsky.social

0104

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

🚨 SPECTACULAR RCT at #ISTH2025! Although non-inferiority to CTPA wasn’t shown, a negative SPECT V/Q scan led to low 3-month VTE risk— ✅ Supporting the safety of ruling out PE with a SPECT-based algorithm 📸 PE diagnosis rates matched other validated strategies SPECTacular findings indeed! 🫁💥

043

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

🩸 WaVE Study Alert! In patients with acute CAT & weight >90kg, weight-based dalteparin (200 IU/kg) appears safe & effective. 🔹 Anti-Xa levels aligned with non-obese patients 🔹 Higher levels seen in those with bleeding Important data to guide dosing CAT & obesity. 📍Presented by Dr. Wang at #ISTH2025

153

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

📣 ARIVA Trial at #ISTH2025: 🧪 First RCT on antithrombotic therapy post-venous stenting for PTS 🔵 6-month primary patency rate was higher than expected 💊 No added benefit of aspirin + rivaroxaban vs. rivaroxaban alone www.ahajournals.org/doi/10.1161/...

033

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

📢 Long-term results from the CELEST trial presented at #ISTH2025: 🧦 No difference in burdensome PTS (~10%) between 25 vs. 35 mmHg ECS after proximal DVT. ✅ Compliance (>50% use) significantly lowers risk. 🔁 Findings reinforce 2-year RCT data. 📌 A placebo-controlled RCT is still needed.

032

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

Great provocative SOA by Dr. Eikeilboom: are there settings where warfarin outperforms DOACs in AF?💊 Emerging data suggest lower mortality & better overall clinical benefit in AF with obesity or rheumatic disease, possibly via GAS6 inhibition #ISTH2025 #AF #Thrombosis

042

Marc Carrier, MD @marccarriermd.bsky.social · 24/06/2025

🩸 Important findings from Dr @IMYanXu at #ISTH2025: Black individuals on extended anticoagulation for secondary VTE prevention had higher rates of major bleeding, including ICH, than White individuals. 🔎 No difference in CRNMB. 📢 Calls for action to address racial disparities.

084

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

🧠 #ISTH2025 SCC survey on stroke in cancer patients: 1️⃣ Physicians choose reperfusion strategies differently for patients with vs. without cancer 2️⃣ Antiplatelets remain the most used for secondary prevention 3️⃣ Major equipoise on workup post-stroke in cancer what is the standard of care?

051

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

🩸 New insights from the RENOVE trial (extended duration anticoagulation) at #ISTH2025: 📉 Reduced-dose DOAC is non-inferior in patients with BMI <30, with less bleeding risk. ⚠️ But in patients with BMI ≥30, reduced-dose may be inferior for bleeding and recurrent VTE. ➡️ Dose matters! @isth.org

054

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

Meta-analysis on GLP-1RA (vs. placebo) and VTE: 🔹 PE rates significantly lower 📉 🔹 VTE rates lower but not statistically significant 🔹 No difference in DVT 🔹 Study design matters: RCTs vs. observational data Accepted for publication in JTH! #ISTH2025 #VTE #GLP1RA #Thrombosis @jthjournal.bsky.social

0167

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

Come say hello to David Airdrie, our Executive Director at Thrombosis Canada, at Booth 623! 👋 Learn more about our clinical guides, patient resources, and upcoming education initiatives. 📍 #ISTH2025 We’re here to connect! #ThrombosisCanada #VTE @thrombosiscan.bsky.social

030

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

📉 GLP-1RA linked to ~25% lower VTE risk vs. other weight-loss meds in a target trial emulation. ⚖️ No difference when compared to bariatric surgery. Important findings on obesity, meds, and thrombosis risk. #ISTH2025 #VTE #GLP1RA

051

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

📢 Adjust-DVT delivers practice-changing evidence! Age-adjusted D-dimer safely rules out DVT in patients with low or non-high pretest probability—reducing the need for ultrasounds. ✅ +17% yield in patients ≥75 years #ISTH2025 #DVT #Thrombosis #VTE

032

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

🩸 Clots strike twice—often in the same place. In a study of 708 patients with prior VTE, most recurrent events occurred at the same site as the original, especially in the same leg for prior DVT. #ISTH2025 #VTE #DVT #Thrombosis

2124

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

🫁 A COPD-specific PE diagnostic strategy was retrospectively validated and shown to be safe. Using a simple 3-item score + D-dimer (2 cut-offs), 50% of patients could avoid imaging. 🔹 DVT signs 🔹 Non-purulent AECOPD 🔹 PE as most likely dx #ISTH2025 #VTE #COPD

051

Marc Carrier, MD @marccarriermd.bsky.social · 23/06/2025

📸 The Ottawa Thrombosis teams out celebrating wins and milestones at #ISTH2025! Proud of the science, the teamwork, and this amazing community. 🩸🥂

090

Marc Carrier, MD @marccarriermd.bsky.social · 22/06/2025

🩸 A new meta-analysis presented at #ISTH2025 and published in European Heart Journal identifies key risk factors (e.g., prior VTE or bleeding, advanced cancer, and certain cancer sites) linked to recurrent VTE and bleeding in patients with CAT 🔗 academic.oup.com/eurheartj/ad...

052

Marc Carrier, MD @marccarriermd.bsky.social · 22/06/2025

🩸 Curious if abiraterone interacts with DOACs in cancer patients? A large population-based study in men with prostate cancer found no increased bleeding risk with concurrent abiraterone + DOACs vs. other anticoagulants. 📍 #ISTH2025 📸 See findings below 👇

030

Marc Carrier, MD @marccarriermd.bsky.social · 22/06/2025

Tissue factor (TF) >130 pg/mL in acute PE = higher death risk. TF may enhance risk scores & guide targeted therapies. Larger trials are warranted. Important insights from #ISTH2025 📷⬇️

021

Reposted by Marc Carrier, MD

Saskia Middeldorp @middeldorps.bsky.social · 22/06/2025

This is what we were waiting for. A direct comparison between apixaban and rivaroxaban for the treatment of acute VTE. Apixaban reduces bleeding risk in the first 3 months by >50%! Practice changing investigator-initiated RCT. #ISTH2025

47237

Marc Carrier, MD @marccarriermd.bsky.social · 22/06/2025

VTE isn’t “over” at discharge. Many patients face lasting symptoms & distress. 🗣️ PROMs help reveal what matters, if we use them right. ✅ Ask ✅ Act ✅ Guide care Structured models like Attend-PE show the way. #ISTH2025 #Thrombosis #PatientVoice

043

Marc Carrier, MD @marccarriermd.bsky.social · 22/06/2025

📈 Disparities in #VTE care remain a major challenge. 🧬 Race, income, region & rurality affect: • Incidence • Access to DOACs • Mortality rates We need targeted solutions rooted in data & equity. #ISTH2025 #HealthEquity #Thrombosis

035

Marc Carrier, MD @marccarriermd.bsky.social · 21/06/2025

In non-critically ill COVID-19 patients, therapeutic-dose anticoagulation reduced the odds of organ support, thrombosis, or death at 28 days. 🔴 Bleeding risk increased, but absolute risk stayed low. No high-credibility effect modifiers identified. 👏 Nice work @TritschlerMD #ISTH2025 #COVID19 #VTE

0105

Marc Carrier, MD @marccarriermd.bsky.social · 21/06/2025

New network meta-analysis on thromboprophylaxis in medical inpatients: ✅ LMWH works well ⚠️ DOACs & UFH are effective, but less safe ⏱️ Duration ≥6 days 🔍 Emphasizes the need for baseline risk stratification #VTE #Thrombosis #ISTH2025

040

Marc Carrier, MD @marccarriermd.bsky.social · 21/06/2025

⏱️ In intermediate–high risk PE, delaying anticoagulation can be deadly. A doubling in time to start treatment = 2.7 X higher risk of PE-related death. Act fast. #VTE #PulmonaryEmbolism #ISTH2025

051

Marc Carrier, MD @marccarriermd.bsky.social · 21/06/2025

🧬 Thinking about thrombophilia testing? It’s not just about who to test — but which test to use! The latest ISTH SSC guidance outlines best practices and recommendations for lab selection and testing reliability. Check it out before you test. #ISTH2025 @isth.org

082

Reposted by Marc Carrier, MD

International Society on Thrombosis and Haemostasis @isth.org · 02/06/2025

🚨Calling all ISTH members! The SSC is seeking new Subcommittee Co-Chairs to join its vital scientific mission. This is a unique opportunity to collaborate with experts, drive scientific progress, and serve the global ISTH community. Click here to learn more: www.isth.org/news/news.as...

033

Marc Carrier, MD @marccarriermd.bsky.social · 24/05/2025

🎉 A huge thank you to our incredible Adult Thrombosis Medicine International Fellows at @uottawa.ca ! We're proud to celebrate the end of your training and a truly successful year. Your dedication and impact have been outstanding. 👏🩺🌍 @canvector.bsky.social @isth.org

061

Marc Carrier, MD @marccarriermd.bsky.social · 03/05/2025

Have you ever wondered about the long-term risk of recurrence in patients with isolated SSPE? Fresh data suggest the risk may not exceed the threshold for extended anticoagulation—but decisions should be made on a case-by-case basis. 👉 www.sciencedirect.com/science/arti...

sciencedirect.com

Letter-To-The-Editor: Long-term outcomes of patients with isolated subsegmental pulmonary embolism managed without anticoagulant therapy

The management of patients with subsegmental pulmonary embolism (SSPE) is controversial. The long-term risk of recurrent venous thromboembolism (VTE) …

062

Marc Carrier, MD @marccarriermd.bsky.social · 28/04/2025

🚨 New study alert: Attempting FXa inhibitor reversal with andexanet before urgent cardiac surgery may lead to heparin resistance. Caution is needed! Elegant editorial reviewing the mechanisms www.sciencedirect.com/science/arti... 🫀 #MedTwitter #CardioTwitter #VTE @jthjournal.bsky.social @isth.org

053

Reposted by Marc Carrier, MD

Marc Carrier, MD @marccarriermd.bsky.social · 29/03/2025

Prof. @isabellemahe.bsky.social presents API-CAT at @accintouch.bsky.social published in @nejm.org: Extended anticoagulation with reduced-dose apixaban is noninferior to full-dose for preventing recurrent VTE, with less clinically relevant bleeding 🩸in cancer patients www.nejm.org/doi/full/10....

0109

Marc Carrier, MD @marccarriermd.bsky.social · 29/03/2025

0109

Marc Carrier, MD @marccarriermd.bsky.social · 07/03/2025

The Repeat Study addressed a really important knowledge gap! The incidence of recurrent events following an ante- or postpartum VTE is 2.4% person-years. The cumulative risks are 6%, 13%, 17%, and 30% at 2, 5, 10, and 30 years respectively www.jthjournal.org/article/S153... @jthjournal.bsky.social

jthjournal.org

High risk of long-term recurrence after a first episode of venous thromboembolism during pregnancy or postpartum: the REcurrence after a PrEgnAncy related Thrombosis (REPEAT) Study

The long-term recurrence risk after a pregnancy-associated venous thromboembolism (VTE) is sparsely assessed.

082

Marc Carrier, MD @marccarriermd.bsky.social · 27/02/2025

Cancer-associated thrombosis is not only about venous events. Patients with cancer and no prior strokes have a 1.5 ⬆️risk of ischemic stroke compared to those without cancer. ⬆️risk with certain tumor types. www.sciencedirect.com/science/arti... @drdebthrombo.bsky.social @jthjournal.bsky.social

sciencedirect.com

Risk of ischemic stroke after cancer diagnosis: a population-based matched cohort study

There are limited data regarding the association between cancer and ischemic stroke, particularly among individuals with previous stroke.Our objective…

0122

Marc Carrier, MD @marccarriermd.bsky.social · 13/02/2025

Did you know? Around 50% of patients with acute CAT in your practice do not meet the inclusion criteria of the RCTs. Listen to the podcast with @gbarnesmd.bsky.social about recent trials taking a more pragmatic approach. www.medthority.com/medical-educ...

medthority.com

Podcast series: 'Thrombosis in conversation'

Podcast series with thrombosis experts

075

Marc Carrier, MD @marccarriermd.bsky.social · 22/01/2025

Interesting results with abelacimab in patients with A Fib @NEJM👇 Can uncoupling hemostasis and thrombosis by blocking activation of FXI also help address unmet needs in cancer-associated thrombosis? Can’t wait to see the results of the on-going ASTER and MAGNOLIA trials www.nejm.org/doi/full/10....

nejm.org

Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation | NEJM

Abelacimab is a fully human monoclonal antibody that binds to the inactive form of factor XI and blocks its activation. The safety of abelacimab as compared with a direct oral anticoagulant in pati...

0124