<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04480892</url>
  </required_header>
  <id_info>
    <org_study_id>212490</org_study_id>
    <nct_id>NCT04480892</nct_id>
  </id_info>
  <brief_title>Fibrinolytic Deficit in Patients With Acute PE</brief_title>
  <official_title>Fibrinolytic Deficit in Patients With Acute Pulmonary Embolism</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Loyola University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Boston Scientific Corporation</agency>
      <agency_class>Industry</agency_class>
    </collaborator>
  </sponsors>
  <source>Loyola University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Fibrinolysis is the body's process that prevents blood clots. The investigators hypothesize&#xD;
      that patients presenting with acute pulmonary embolism (PE) or blood clots in the lungs&#xD;
      differ in their fibrinolytic deficit phenotype. The investigators aim to use biomarkers&#xD;
      directly involved in endogenous fibrinolytic cascade including PAI-1, Alpha-2-Antiplasmin&#xD;
      (A2A), TAFI, D-dimer, and Fibrinogen to phenotypically characterize patients presenting with&#xD;
      acute PE and to correlate these biomarkers with clinical, echocardiographic, computed&#xD;
      tomography (CT), and functional status outcomes.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Patients (n=100) identified by the Pulmonary Embolism Response Team (PERT) suffering from a&#xD;
      PE will be identified by the PI. Blood plasma samples from these patients which have been&#xD;
      drawn for routine lab tests will be identified and the Sub-I who will pick the samples up&#xD;
      from the clinical lab after the routine analysis has been completed. These samples will be&#xD;
      de-identified by giving them a study number. These samples will be recentrifuged and&#xD;
      aliquoted. Samples will be stored in a -80ᵒC freezer in the Hemostasis &amp; Thrombosis Research&#xD;
      Laboratory. When all 100 de-identified samples have been collected they will be analyzed&#xD;
      blindly by the technical staff of the hemostasis laboratory for the fibrinolytic parameters&#xD;
      PAI-1, Alpha-2-Antiplasmin, TAFI, tPA, D-dimer, Plasminogen, and Fibrinogen. PAI-1 and TAFI&#xD;
      will be quantified with an Enzyme Linked-Immuno-Sorbent Assay (ELISA), while A2A is measured&#xD;
      using functional assay. PAI-1 is measured as ug/ml, while TAFI and A2A are measured as % of&#xD;
      normal controls. Normal controls are derived from pooled normal human plasma from volunteers&#xD;
      purchased from outside vendor. Results will be compiled and sent to the PERT team for&#xD;
      analysis and correlation withclinical, echocardiographic, computed tomography (CT), and&#xD;
      functional status outcomes.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Not yet recruiting</overall_status>
  <start_date type="Anticipated">August 2020</start_date>
  <completion_date type="Anticipated">December 2024</completion_date>
  <primary_completion_date type="Anticipated">December 2023</primary_completion_date>
  <study_type>Observational [Patient Registry]</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <target_duration>1 Day</target_duration>
  <primary_outcome>
    <measure>Plasminogen Activator Inhibitor-1 (PAI-1)</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for PAI-1 level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Alpha-2 Antiplasmin level (A2P)</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for A2P level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Thrombin Activatable Fibrinolysis Inhibitor (TAFI)</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for TAFI level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Tissue plasminogen activator (tPA)</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for tPA level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>D-dimer</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for D-dimer level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Plasminogen</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for Plasminogen level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Fibrinogen</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Laboratory analysis of blood sample for Fibrinogen level</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Clinical Presentation Risk Score</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Based on vital signs (heart rate, blood pressure, oxygen requirements, and labs (CBC, lactate, troponin, and BNP, clinical presentation will be characterized as low, intermediate, or high risk.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Right Ventricular Function</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Assessed by echocardiography</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Pulmonary Artery Pressure</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Pulmonary Artery Pressure (mmHg) will be measured for patients escalated to endovascular therapies in the cardiac cath laboratory</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Cardiac Output</measure>
    <time_frame>Baseline-Day 1</time_frame>
    <description>Cardiac Output, the volume of blood pumped from the ventricle per heartbeat (mL/min), will be measured for patients escalated to endovascular therapies in the cardiac cath laboratory.</description>
  </primary_outcome>
  <enrollment type="Anticipated">100</enrollment>
  <condition>Acute Pulmonary Embolism</condition>
  <condition>Fibrinolytic Deficit</condition>
  <biospec_retention>Samples With DNA</biospec_retention>
  <biospec_descr>
    <textblock>
      Blood samples drawn for clinical evaluation of PE will be collected after analysis complete,&#xD;
      de-identified, re-centrifuged, aliquoted, and stored in -80 freezer. Once all 100 patient&#xD;
      samples have been collected, samples will be analyzed for fibrinolytic biomarkers.&#xD;
    </textblock>
  </biospec_descr>
  <eligibility>
    <study_pop>
      <textblock>
        Patients with acute PE being treated by the PERT.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Patients age 18 - 90 years&#xD;
&#xD;
          -  Patients suffering an acute PE&#xD;
&#xD;
          -  Blood collected for clinical evaluation of PE&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Blood not collected or not sufficient quantity/quality&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>90 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Amir Darki, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Loyola University</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Amir Darki, MD</last_name>
    <phone>708-216-4466</phone>
    <email>adarki@lumc.edu</email>
  </overall_contact>
  <location>
    <facility>
      <name>Loyola University Medical Center</name>
      <address>
        <city>Maywood</city>
        <state>Illinois</state>
        <zip>60153</zip>
        <country>United States</country>
      </address>
    </facility>
    <contact>
      <last_name>Amir Darki, MD</last_name>
      <phone>708-216-4466</phone>
      <email>adarki@lumc.edu</email>
    </contact>
    <investigator>
      <last_name>Debra Hoppensteadt-Moorman, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <reference>
    <citation>Meyer G, Vicaut E, Danays T, Agnelli G, Becattini C, Beyer-Westendorf J, Bluhmki E, Bouvaist H, Brenner B, Couturaud F, Dellas C, Empen K, Franca A, Galie N, Geibel A, Goldhaber SZ, Jimenez D, Kozak M, Kupatt C, Kucher N, Lang IM, Lankeit M, Meneveau N, Pacouret G, Palazzini M, Petris A, Pruszczyk P, Rugolotto M, Salvi A, Schellong S, Sebbane M, Sobkowicz B, Stefanovic BS, Thiele H, Torbicki A, Verschuren F, Konstantinides SV; PEITHO Investigators. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014 Apr 10;370(15):1402-11. doi: 10.1056/NEJMoa1302097.</citation>
    <PMID>24716681</PMID>
  </reference>
  <reference>
    <citation>Kucher N, Boekstegers P, Muller OJ, Kupatt C, Beyer-Westendorf J, Heitzer T, Tebbe U, Horstkotte J, Muller R, Blessing E, Greif M, Lange P, Hoffmann RT, Werth S, Barmeyer A, Hartel D, Grunwald H, Empen K, Baumgartner I. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation. 2014 Jan 28;129(4):479-86. doi: 10.1161/CIRCULATIONAHA.113.005544. Epub 2013 Nov 13.</citation>
    <PMID>24226805</PMID>
  </reference>
  <reference>
    <citation>Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, Kumbhani DJ, Mukherjee D, Jaff MR, Giri J. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA. 2014 Jun 18;311(23):2414-21. doi: 10.1001/jama.2014.5990.</citation>
    <PMID>24938564</PMID>
  </reference>
  <reference>
    <citation>Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M; &quot;MOPETT&quot; Investigators. Moderate pulmonary embolism treated with thrombolysis (from the &quot;MOPETT&quot; Trial). Am J Cardiol. 2013 Jan 15;111(2):273-7. doi: 10.1016/j.amjcard.2012.09.027. Epub 2012 Oct 24.</citation>
    <PMID>23102885</PMID>
  </reference>
  <reference>
    <citation>Zhang Z, Zhai ZG, Liang LR, Liu FF, Yang YH, Wang C. Lower dosage of recombinant tissue-type plasminogen activator (rt-PA) in the treatment of acute pulmonary embolism: a systematic review and meta-analysis. Thromb Res. 2014 Mar;133(3):357-63. doi: 10.1016/j.thromres.2013.12.026. Epub 2013 Dec 23.</citation>
    <PMID>24412030</PMID>
  </reference>
  <reference>
    <citation>Piazza G, Hohlfelder B, Jaff MR, Ouriel K, Engelhardt TC, Sterling KM, Jones NJ, Gurley JC, Bhatheja R, Kennedy RJ, Goswami N, Natarajan K, Rundback J, Sadiq IR, Liu SK, Bhalla N, Raja ML, Weinstock BS, Cynamon J, Elmasri FF, Garcia MJ, Kumar M, Ayerdi J, Soukas P, Kuo W, Liu PY, Goldhaber SZ; SEATTLE II Investigators. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. JACC Cardiovasc Interv. 2015 Aug 24;8(10):1382-1392. doi: 10.1016/j.jcin.2015.04.020.</citation>
    <PMID>26315743</PMID>
  </reference>
  <reference>
    <citation>Tapson VF, Sterling K, Jones N, Elder M, Tripathy U, Brower J, Maholic RL, Ross CB, Natarajan K, Fong P, Greenspon L, Tamaddon H, Piracha AR, Engelhardt T, Katopodis J, Marques V, Sharp ASP, Piazza G, Goldhaber SZ. A Randomized Trial of the Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Intermediate-Risk Pulmonary Embolism: The OPTALYSE PE Trial. JACC Cardiovasc Interv. 2018 Jul 23;11(14):1401-1410. doi: 10.1016/j.jcin.2018.04.008.</citation>
    <PMID>30025734</PMID>
  </reference>
  <reference>
    <citation>Brailovsky, Y. et al. NOVEL BIOMARKERS FOR RISK STRATIFICATION IN ACUTE PULMONARY EMBOLISM. J. Am. Coll. Cardiol. 73, 2088 (2019</citation>
  </reference>
  <reference>
    <citation>Part 6: Hemostasis and Thrombosis, Chapter 35: Normal Hemostasis, Fibrinolysis, p. 642-645. Rodak's Hematology. (Saunders, 2020)</citation>
  </reference>
  <verification_date>July 2020</verification_date>
  <study_first_submitted>June 28, 2020</study_first_submitted>
  <study_first_submitted_qc>July 16, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">July 22, 2020</study_first_posted>
  <last_update_submitted>July 16, 2020</last_update_submitted>
  <last_update_submitted_qc>July 16, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">July 22, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Loyola University</investigator_affiliation>
    <investigator_full_name>Amir Darki</investigator_full_name>
    <investigator_title>Associate Professor</investigator_title>
  </responsible_party>
  <keyword>Acute Pulmonary Embolism</keyword>
  <keyword>Fibrinolytic System</keyword>
  <keyword>Fibrinolysis</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Pulmonary Embolism</mesh_term>
    <mesh_term>Embolism</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04480892
org study id: 212490
nct id: NCT04480892
lead sponsor: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Fibrinolysis is the body's process that prevents blood clots. The investigators hypothesize
      that patients presenting with acute pulmonary embolism (PE) or blood clots in the lungs
      differ in their fibrinolytic deficit phenotype. The investigators aim to use biomarkers
      directly involved in endogenous fibrinolytic cascade including PAI-1, Alpha-2-Antiplasmin
      (A2A), TAFI, D-dimer, and Fibrinogen to phenotypically characterize patients presenting with
      acute PE and to correlate these biomarkers with clinical, echocardiographic, computed
      tomography (CT), and functional status outcomes.
Patients (n=100) identified by the Pulmonary Embolism Response Team (PERT) suffering from a
      PE will be identified by the PI. Blood plasma samples from these patients which have been
      drawn for routine lab tests will be identified and the Sub-I who will pick the samples up
      from the clinical lab after the routine analysis has been completed. These samples will be
      de-identified by giving them a study number. These samples will be recentrifuged and
      aliquoted. Samples will be stored in a -80ᵒC freezer in the Hemostasis & Thrombosis Research
      Laboratory. When all 100 de-identified samples have been collected they will be analyzed
      blindly by the technical staff of the hemostasis laboratory for the fibrinolytic parameters
      PAI-1, Alpha-2-Antiplasmin, TAFI, tPA, D-dimer, Plasminogen, and Fibrinogen. PAI-1 and TAFI
      will be quantified with an Enzyme Linked-Immuno-Sorbent Assay (ELISA), while A2A is measured
      using functional assay. PAI-1 is measured as ug/ml, while TAFI and A2A are measured as % of
      normal controls. Normal controls are derived from pooled normal human plasma from volunteers
      purchased from outside vendor. Results will be compiled and sent to the PERT team for
      analysis and correlation withclinical, echocardiographic, computed tomography (CT), and
      functional status outcomes.
observational model: Cohort
time perspective: Prospective
measure: Plasminogen Activator Inhibitor-1 (PAI-1)
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for PAI-1 level
measure: Alpha-2 Antiplasmin level (A2P)
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for A2P level
measure: Thrombin Activatable Fibrinolysis Inhibitor (TAFI)
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for TAFI level
measure: Tissue plasminogen activator (tPA)
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for tPA level
measure: D-dimer
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for D-dimer level
measure: Plasminogen
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for Plasminogen level
measure: Fibrinogen
time frame: Baseline-Day 1
description: Laboratory analysis of blood sample for Fibrinogen level
measure: Clinical Presentation Risk Score
time frame: Baseline-Day 1
description: Based on vital signs (heart rate, blood pressure, oxygen requirements, and labs (CBC, lactate, troponin, and BNP, clinical presentation will be characterized as low, intermediate, or high risk.
measure: Right Ventricular Function
time frame: Baseline-Day 1
description: Assessed by echocardiography
measure: Pulmonary Artery Pressure
time frame: Baseline-Day 1
description: Pulmonary Artery Pressure (mmHg) will be measured for patients escalated to endovascular therapies in the cardiac cath laboratory
measure: Cardiac Output
time frame: Baseline-Day 1
description: Cardiac Output, the volume of blood pumped from the ventricle per heartbeat (mL/min), will be measured for patients escalated to endovascular therapies in the cardiac cath laboratory.
Blood samples drawn for clinical evaluation of PE will be collected after analysis complete,
      de-identified, re-centrifuged, aliquoted, and stored in -80 freezer. Once all 100 patient
      samples have been collected, samples will be analyzed for fibrinolytic biomarkers.
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 18 Years
maximum age: 90 Years
healthy volunteers: No
last name: Amir Darki, MD
role: Principal Investigator
affiliation: Loyola University
last name: Amir Darki, MD
phone: 708-216-4466
email: adarki@lumc.edu
facility: 
contact: 
investigator: 
country: United States
citation: Meyer G, Vicaut E, Danays T, Agnelli G, Becattini C, Beyer-Westendorf J, Bluhmki E, Bouvaist H, Brenner B, Couturaud F, Dellas C, Empen K, Franca A, Galie N, Geibel A, Goldhaber SZ, Jimenez D, Kozak M, Kupatt C, Kucher N, Lang IM, Lankeit M, Meneveau N, Pacouret G, Palazzini M, Petris A, Pruszczyk P, Rugolotto M, Salvi A, Schellong S, Sebbane M, Sobkowicz B, Stefanovic BS, Thiele H, Torbicki A, Verschuren F, Konstantinides SV; PEITHO Investigators. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014 Apr 10;370(15):1402-11. doi: 10.1056/NEJMoa1302097.
PMID: 24716681
citation: Kucher N, Boekstegers P, Muller OJ, Kupatt C, Beyer-Westendorf J, Heitzer T, Tebbe U, Horstkotte J, Muller R, Blessing E, Greif M, Lange P, Hoffmann RT, Werth S, Barmeyer A, Hartel D, Grunwald H, Empen K, Baumgartner I. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation. 2014 Jan 28;129(4):479-86. doi: 10.1161/CIRCULATIONAHA.113.005544. Epub 2013 Nov 13.
PMID: 24226805
citation: Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, Kumbhani DJ, Mukherjee D, Jaff MR, Giri J. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA. 2014 Jun 18;311(23):2414-21. doi: 10.1001/jama.2014.5990.
PMID: 24938564
citation: Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M; "MOPETT" Investigators. Moderate pulmonary embolism treated with thrombolysis (from the "MOPETT" Trial). Am J Cardiol. 2013 Jan 15;111(2):273-7. doi: 10.1016/j.amjcard.2012.09.027. Epub 2012 Oct 24.
PMID: 23102885
citation: Zhang Z, Zhai ZG, Liang LR, Liu FF, Yang YH, Wang C. Lower dosage of recombinant tissue-type plasminogen activator (rt-PA) in the treatment of acute pulmonary embolism: a systematic review and meta-analysis. Thromb Res. 2014 Mar;133(3):357-63. doi: 10.1016/j.thromres.2013.12.026. Epub 2013 Dec 23.
PMID: 24412030
citation: Piazza G, Hohlfelder B, Jaff MR, Ouriel K, Engelhardt TC, Sterling KM, Jones NJ, Gurley JC, Bhatheja R, Kennedy RJ, Goswami N, Natarajan K, Rundback J, Sadiq IR, Liu SK, Bhalla N, Raja ML, Weinstock BS, Cynamon J, Elmasri FF, Garcia MJ, Kumar M, Ayerdi J, Soukas P, Kuo W, Liu PY, Goldhaber SZ; SEATTLE II Investigators. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. JACC Cardiovasc Interv. 2015 Aug 24;8(10):1382-1392. doi: 10.1016/j.jcin.2015.04.020.
PMID: 26315743
citation: Tapson VF, Sterling K, Jones N, Elder M, Tripathy U, Brower J, Maholic RL, Ross CB, Natarajan K, Fong P, Greenspon L, Tamaddon H, Piracha AR, Engelhardt T, Katopodis J, Marques V, Sharp ASP, Piazza G, Goldhaber SZ. A Randomized Trial of the Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Intermediate-Risk Pulmonary Embolism: The OPTALYSE PE Trial. JACC Cardiovasc Interv. 2018 Jul 23;11(14):1401-1410. doi: 10.1016/j.jcin.2018.04.008.
PMID: 30025734
citation: Brailovsky, Y. et al. NOVEL BIOMARKERS FOR RISK STRATIFICATION IN ACUTE PULMONARY EMBOLISM. J. Am. Coll. Cardiol. 73, 2088 (2019
citation: Part 6: Hemostasis and Thrombosis, Chapter 35: Normal Hemostasis, Fibrinolysis, p. 642-645. Rodak's Hematology. (Saunders, 2020)
responsible party type: Principal Investigator
investigator affiliation: Loyola University
investigator full name: Amir Darki
investigator title: Associate Professor
mesh term: Pulmonary Embolism
mesh term: Embolism
sharing ipd: No