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  • HP:0005521: Disseminated intravascular coagulation
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    HP:0005521: Disseminated intravascular coagulation

    Developed by Shray Alag, The Harker School
    Sections: Correlations, Clinical Trials, and HPO

    Correlations computed by analyzing all clinical trials.

    Navigate: Clinical Trials and HPO


    Correlated Drug Terms (13)


    Name (Synonyms) Correlation
    drug3359 Thrombin Generation Assay (TGA) Wiki 0.45
    drug291 Assessment of coagulopathy, Platelets activation and Platelets-Neutrophils interplay Wiki 0.45
    drug3360 Thrombin generation test assay Wiki 0.45
    Name (Synonyms) Correlation
    drug3361 Thrombomodulin Modified Thrombin Generation Assay (TGA-TM) Wiki 0.45
    drug579 COVID Watch Wiki 0.45
    drug284 Aspirin 81 mg Wiki 0.45
    drug1277 Fibrin generation markers assays Wiki 0.45
    drug3969 pulse oximeter Wiki 0.45
    drug2677 Quantra System Wiki 0.45
    drug3742 convalescent plasma Wiki 0.37
    drug582 COVID-19 Wiki 0.20
    drug587 COVID-19 Convalescent Plasma Wiki 0.20
    drug3574 Vitamin D Wiki 0.13

    Correlated MeSH Terms (9)


    Name (Synonyms) Correlation
    D004211 Disseminated Intravascular Coagulation NIH 1.00
    D020141 Hemostatic Disorders NIH 0.35
    D001778 Blood Coagulation Disorders NIH 0.35
    Name (Synonyms) Correlation
    D012772 Shock, Septic NIH 0.32
    D012769 Shock, NIH 0.17
    D014808 Vitamin D Deficiency NIH 0.14
    D016638 Critical Illness NIH 0.06
    D014777 Virus Diseases NIH 0.05
    D007239 Infection NIH 0.02

    Correlated HPO Terms (2)


    Name (Synonyms) Correlation
    HP:0001928 Abnormality of coagulation HPO 0.35
    HP:0100512 Low levels of vitamin D HPO 0.14

    Clinical Trials

    Navigate: Correlations   HPO

    There are 5 clinical trials


    1 Prospective Evaluation of PLatelets Acetyl-CoA Carboxylase Phosphorylation State in SEPtic Shock Patients. Impact of Platelets Metabolism to Inflammatory Response.

    Knowing the dramatic increase in thrombin generation during sepsis, our research hypothesis is that AMPK-induced ACC phosphorylation in platelets is increased and that this might modulate platelets metabolism and more particularly platelets inflammatory mediators content, coming from AA and lipids.

    NCT04107402
    Conditions
    1. Septic Shock
    2. Platelet Signal Processing Defect
    3. Inflammatory Response
    4. Disseminated Intravascular Coagulation
    5. Covid19
    6. Neutrophil Extracellular Trap Formation
    Interventions
    1. Other: Assessment of coagulopathy, Platelets activation and Platelets-Neutrophils interplay
    MeSH:Shock, Septic Disseminated Intravascular Coagulation Shock
    HPO:Disseminated intravascular coagulation

    Primary Outcomes

    Description: ACC phosphorylation on Ser79 (phosphoACC) in platelets of patients will be assessed using western blotting. Results will be expressed in arbitrary units (A.U). A signal above 0.5 A.U. has already been shown to be above 2 standard deviation in a healthy population.

    Measure: Platelets Acetyl-CoA Carboxylase phosphorylation rate

    Time: At the time of inclusion

    Secondary Outcomes

    Description: Sepsis severity will be assessed using the SOFA score (Sepsis-related Organ Failure Assessment). Range from 0( less severe) to 24 (more severe).

    Measure: Sepsis severity

    Time: At the time of inclusion

    Description: Sepsis severity will be assessed using the APACHE II score) Acute Physiology And Chronic Health Evaluation) Range 0 (less severe) to 299 (more severe).

    Measure: Sepsis severity

    Time: At the time of inclusion

    Measure: Mortality rate

    Time: 30 days and 1-year follow-up

    Description: Platelet function will be assessed using platelets aggregometry. The Aggregation (in AU), the maximum height of the curve during the measurement period will be assessed.

    Measure: Platelet function assessment

    Time: At the time of inclusion

    Description: Platelet function will be assessed using platelets aggregometry. Area Under the aggregation Curve (AUC) will be assessed and recorded as Units or U.

    Measure: Platelet function assessment

    Time: At the time of inclusion

    Description: Platelet function will be assessed using platelets aggregometry. Velocity (in AU/min), the maximum slope of the curve will be assessed.

    Measure: Platelet function assessment

    Time: At the time of inclusion

    Description: D-Dimers (ng/ml)

    Measure: Thrombin generation marker rate

    Time: At the time of inclusion

    Description: Urinary Thrombin-antithrombin complex (ng/mL)

    Measure: Thrombin generation marker rate

    Time: At the time of inclusion

    Description: Tubulin acetylation will be assessed using western blotting. Results will be expressed in arbitrary units (A.U).

    Measure: Tubulin acetylation rate

    Time: At the time of inclusion

    Description: Total platelets lipid content and composition will be assessed using metabolomics approach by Mass Spectrometry. Fold-change estimates and corresponding P values were derived from regression models for each lipid species and each predictor. To control for multiple testing, all P values will be further adjusted for Benjamini-Hochberg false discovery rate (FDR), with a FDR <0.05 considered statistically significant

    Measure: Total platelets lipid content and composition

    Time: At the time of inclusion

    Description: Myeloperoxidase MPO (ng/mL)

    Measure: Neutrophils extracellular trap formation

    Time: At the time of inclusion

    Description: Citrulinated Histon 3 H3-Cit (ng/mL)

    Measure: Neutrophils extracellular trap formation

    Time: At the time of inclusion

    Description: Soluble CD62P (ng/mL)

    Measure: Platelets activation

    Time: At the time of inclusion

    Description: PaO2/FiO2

    Measure: Respiratory failure

    Time: At the time of inclusion and through study completion up to day 30
    2 Coagulation Assays in the Critically Ill Patient: a New Approach Using the Thrombomodulin-modified Thrombin Generation Assay (TGA-TM)

    Inflammation and abnormalities in laboratory coagulation tests are inseparably tied. For example, coagulation abnormalities are nearly universal in septic patients. Coagulation disorders have also been reported in many patients with severe courses of Coronavirus disease 2019 (Covid-19). But it is difficult to assess these changes. Global coagulation tests have been shown to incorrectly assess in vivo coagulation in patients admitted to intensive care units. But other tests are available. Thrombin generation assay (TGA) is a laboratory test which allows the assessment of an individual's potential to generate thrombin. But also in conventional TGA the protein C system is hardly activated because of the absence of endothelial cells (containing natural thrombomodulin) in the plasma sample. Therefore the investigators add recombinant human thrombomodulin to a conventional TGA. Thereby the investigators hope to be able to depict in vivo coagulation more closely than global coagulation tests do.

    NCT04356144
    Conditions
    1. Disseminated Intravascular Coagulation
    2. Critical Illness
    3. Sars-CoV2
    4. Viral Infection
    5. Coagulation Disorder, Blood
    6. Covid19
    Interventions
    1. Diagnostic Test: Thrombin Generation Assay (TGA)
    2. Diagnostic Test: Thrombomodulin Modified Thrombin Generation Assay (TGA-TM)
    MeSH:Infection Virus Diseases Hemostatic Disorders Blood Coagulation Disorders Disseminated Intravascular Coagulation Critical Illness
    HPO:Abnormality of coagulation Abnormality of the coagulation cascade Disseminated intravascular coagulation

    Primary Outcomes

    Description: nM;

    Measure: ETP (AUC) without rhThrombomodulin (rhTM)

    Time: 6 months

    Description: nM;

    Measure: ETP (AUC) with rhThrombomodulin (rhTM)

    Time: 6 months

    Description: Ratio of endogenous thrombin potential (ETP) with rhTM to ETP without rhTM

    Measure: ETP-ratio

    Time: 6 months

    Description: Comparison of ETP-ratios from ICU patients and ETP-ratios from citrated plasma samples from healthy donors

    Measure: ETP-Normalisation

    Time: 6 months
    3 Analysis of the Coagulopathy Developed by COVID-19 Infected Patients: Thrombin Generation Potential in COVID-19 Infected Patients

    Increased D-dimers at admission of COVID-19 infected patients entering hospital due to a severe disease is a risk factor for death. Understanding this acquired coagulopathy is a prerequisite before specific interventional studies. The study investigators aim to apply a normalized and automated thrombin generation test (TGT), developed for testing the thrombotic risk (triggered by 5 pM Tissue Factor, with a purified thrombomodulin (TM) challenge) and to study its association with survival.

    NCT04356950
    Conditions
    1. Sepsis
    2. Blood Coagulation Disorders
    3. Thrombin
    4. Disseminated Intravascular Coagulation
    5. COVID-19
    Interventions
    1. Other: Thrombin generation test assay
    2. Other: Fibrin generation markers assays
    MeSH:Hemostatic Disorders Blood Coagulation Disorders Disseminated Intravascular Coagulation
    HPO:Abnormality of coagulation Abnormality of the coagulation cascade Disseminated intravascular coagulation

    Primary Outcomes

    Description: Death yes/no during hopstilization, 28 days after admittence

    Measure: 28-day survival rate

    Time: 1 month

    Description: Seconds; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Absolute thrombin generation test latent period

    Time: Day 0

    Description: %; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Relative thrombin generation test latent period compared to reference plasma

    Time: Day 0

    Description: nmol/s; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Absolute thrombin generation test initial velocity

    Time: Day 0

    Description: %; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Relative thrombin generation test initial velocity compared to reference plasma

    Time: Day 0

    Description: %; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Relative thrombin generation test peak thrombin compared to reference plasma

    Time: Day 0

    Description: nmol/L; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Absolute thrombin generation test peak thrombin

    Time: Day 0

    Description: Seconds; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Absolute thrombin generation test peak thrombin time

    Time: Day 0

    Description: %; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Relative thrombin generation test peak thrombin time compared to reference plasma

    Time: Day 0

    Description: seconds; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Absolute thrombin generation test total thrombin generation time

    Time: Day 0

    Description: %; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Relative thrombin generation test total thrombin generation time compared to reference plasma

    Time: Day 0

    Description: Seconds; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Absolute thrombin generation test endogenous thrombin potential

    Time: Day 0

    Description: %; without (TM-) and with (TM+) purified thrombomodulin

    Measure: Relative thrombin generation test endogenous thrombin potential compared to reference plasma

    Time: Day 0

    Secondary Outcomes

    Description: Death yes/no

    Measure: 3-month survival rate

    Time: 3 months

    Description: Yes/no

    Measure: Transfer to intensive care unit during hospitalization

    Time: 3 months

    Description: Yes/no (deep vein thrombosis, pulmonary embolism, atherothrombosis flare, arterial thrombosis)

    Measure: Thrombotic complication during hospitalization

    Time: 3 months

    Description: µg / L, assayed by automated enzyme linked fluorescent assay (Vidas® D-dimers Exclusion ™ II)

    Measure: Plasma concentrations of D-dimers

    Time: Day 0

    Description: mg / L, measured by automated immunoagglutination (STA®-Liatest® FM)

    Measure: Plasma concentrations of soluble fibrin monomers

    Time: Day 0
    4 The LEAD COVID-19 Trial: Low-risk, Early Aspirin and Vitamin D to Reduce COVID-19 Hospitalizations

    Although the novel SARS-CoV-2 virus (COVD-19) is classified as an acute respiratory infection, emerging data show that morbidity and mortality are driven by disseminated intravascular coagulopathy. Untreated CAC leads to microangiopathic thromboses, causing multiple systems organ failure and consuming enormous healthcare resources. Identifying strategies to prevent CAC are therefore crucial to reducing COVID-19 hospitalization rates. The pathogenesis of CAC is unknown, but there are major overlaps between severe COVID-19 and vitamin D insufficiency (VDI). We hypothesize that VDI is a major underlying contributor to CAC. Preliminary data from severe COVID-19 patients in New Orleans support this hypothesis. The purpose of the proposed multi-center, prospective, randomized controlled trial is to test the hypothesis that low-risk, early treatment with aspirin and vitamin D in COVID-19 can mitigate the prothrombotic state and reduce hospitalization rates.

    NCT04363840
    Conditions
    1. COVID
    2. Vitamin D Deficiency
    3. Coagulopathy
    4. Disseminated Intravascular Coagulation
    Interventions
    1. Drug: Aspirin 81 mg
    2. Dietary Supplement: Vitamin D
    MeSH:Disseminated Intravascular Coagulation Vitamin D Deficiency
    HPO:Disseminated intravascular coagulation Low levels of vitamin D

    Primary Outcomes

    Description: Hospitalization for COVID-19 symptoms

    Measure: Hospitalization

    Time: 2 weeks
    5 Exploratory Assessment of the Coagulation Changes Associated With Severe Inflammation in COVID-19 Patients

    This study will study the potential utility of the Quantra QPlus System in patients inflicted with COVID-19 disease.

    NCT04460664
    Conditions
    1. COVID
    2. Disseminated Intravascular Coagulation
    3. Coagulation Disorder
    Interventions
    1. Diagnostic Test: Quantra System
    MeSH:Hemostatic Disorders Blood Coagulation Disorders Disseminated Intravascular Coagulation
    HPO:Abnormality of coagulation Abnormality of the coagulation cascade Disseminated intravascular coagulation

    Primary Outcomes

    Description: Coagulation function assessed by the Quantra

    Measure: Quantra Clot Time results

    Time: Within 24 hours of admission to the hospital

    Description: Coagulation function assessed by the Quantra

    Measure: Quantra Clot Time results

    Time: 48 to 72 hours after transfer to ICU

    Description: Coagulation function assessed by the Quantra

    Measure: Quantra Clot Time results

    Time: 1 to 24 hours prior to discharge from hospital

    Description: Coagulation function assessed by the Quantra

    Measure: Quantra Clot Stiffness results

    Time: Upon arrival at hospital

    Description: Coagulation function assessed by the Quantra

    Measure: Quantra Clot Stiffness results

    Time: 48 to 72 hours after transfer to ICU

    Description: Coagulation function assessed by the Quantra

    Measure: Quantra Clot Stiffness results

    Time: 1 to 24 hours prior to discharge from hospital

    HPO Nodes


    Reports

    Data processed on December 13, 2020.

    An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.

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