Evidence mapPaperPMID 42428488Full record

ReviewFrontiers in cardiovascular medicine2026

From empirical hemostasis to precision reversal: clinical challenges, technological innovations, and individualized strategies in anticoagulant-associated bleeding.

Wei Zheng, Yunqiao Wang, Jing Lu, Mengyang Long, Cuiyao Tang, Zihui Xu, Han Li

Abstract readReview
In one paragraph

Review in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Wei Zheng *Department of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Yunqiao Wang *Department of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Jing LuDepartment of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Mengyang LongDepartment of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Cuiyao TangDepartment of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Zihui XuDepartment of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.
Han LiDepartment of Traditional Chinese Medicine, Second Affiliated Hospital of Army Medical University, Chongqing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Anticoagulant therapy is indispensable for thromboembolism management, yet it presents an inherent pharmacological paradox by elevating the risk of catastrophic hemorrhage. Navigating this dynamic hemostatic equilibrium remains a profound clinical challenge. Pharmacological landscape: This review systematically evaluates the evolution of procoagulant strategies. While specific reversal agents (e.g., idarucizumab, andexanet alfa) have inaugurated an era of targeted precision reversal through high-affinity molecular neutralization, their widespread application is frequently hampered by exorbitant pharmacoeconomic costs, limited accessibility, and latent prothrombotic "off-target" effects (e.g., TFPI inhibition). Conversely, non-specific agents, epitomized by four-factor prothrombin complex concentrate (4F-PCC) and adjunctive antifibrinolytics, retain a foundational, highly cost-effective role in real-world rescue paradigms. Technological innovations: To circumvent existing limitations, current technological trajectories are pivoting towards the rational design of broad-spectrum synthetic molecules (e.g., ciraparantag) and highly programmable nucleic acid aptamer systems. These innovations promise to deliver "on-demand" reversibility and democratize access to hemostatic therapies. Clinical management & perspectives: Translating these pharmacological breakthroughs into optimal patient outcomes necessitates a paradigm shift in clinical workflows. We propose a multidimensional framework driven by point-of-care (POC) viscoelastic testing, algorithmic clinical decision support systems, and sequential therapy pathways managed by multidisciplinary "Code Bleed" teams. Future research must urgently prioritize large-scale, head-to-head randomized trials focused on patient-centered hard endpoints, ultimately refining evidence-based strategies to maximize therapeutic efficacy while strictly mitigating thrombotic risks.

Indexed as

anticoagulantsclinical decision supporthemorrhagepoint-of-Care systemsprecision medicineprothrombin complex concentratesreversal agents

Identifiers

PMID42428488
PMCPMC13345900

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.