Marc Carrier, MD

@marccarriermd.bsky.social

Hematologist 🩸| Blood clot lover | Division Head @Ottawa Hospital | Senior Scientist @OHRI | Professor of Medicine at University of Ottawa

🩸 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.

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🧵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. 🩺📉

🚨 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! 🫁💥

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🩸 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

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📢 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.

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🩸 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.

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🧠 #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?

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🩸 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

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🩸 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 👇

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