Research Topics
Species | Thomas L OrtelSummaryAffiliation: Duke University Medical Center Country: USA Publications
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Publications
Continuing anticoagulation following venous thromboembolismElizabeth Krakow
JAMA 294:3088; author reply 3088-9. 2005- The antiphospholipid syndrome: what are we really measuring? How do we measure it? And how do we treat it?Thomas L Ortel
Division of Hematology, Departments of Medicine and Pathology, Duke University Medical Center, Box 3422, Durham, NC 27710, USA
J Thromb Thrombolysis 21:79-83. 2006..Patients with the antiphospholipid syndrome are treated with long-term oral anticoagulation to prolong the INR to 2.0 to 3.0. For most patients, a more intense level of treatment with a higher INR is not needed... - Prevention and treatment of deep venous thrombosisThomas L Ortel
Duke Hemostasis and Thrombosis Center, Duke University Medical Center, Durham, NC, USA
Vascular 16:S64-70. 2008..Effective thrombo-prophylactic strategies exist and include both pharmacologic and nonpharmacologic approaches. For those surgical patients who develop a VTE, antithrombotic therapy remains the treatment of choice... - Binding of factor VIII inhibitors to discrete regions of the factor VIII C2 domain disrupt phospholipid bindingDeborah A Lewis
Department of Medicine, Division of Hematology, Duke University Medical Center, Durham, North Carolina 27710, USA
Blood Coagul Fibrinolysis 14:361-8. 2003..These results agree with the model of the phospholipid-binding site determined by crystal structure of the C2 domain of factor VIII... - Regulatable aptamers in medicine: focus on antithrombotic strategiesAnil Potti
Duke University Medical Center, Department of Medicine, Division of Haematology, Durham, NC 27710, USA
Expert Opin Biol Ther 4:1641-7. 2004.... 
Anti-heparin/platelet factor 4 antibody optical density values and the confirmatory procedure in the diagnosis of heparin-induced thrombocytopeniaNicole L Whitlatch
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
Thromb Haemost 100:678-84. 2008..Future studies should compare higher ELISA OD values with the confirmatory procedure as strategies to improve ELISA diagnostic specificity for HIT...- Phospholipid vesicles interfere with the binding of antibody fragments to the light chain of factor VIIIDeborah A Lewis
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Thromb Haemost 93:833-41. 2005.... - Clinical practice. Heparin-induced thrombocytopeniaGowthami M Arepally
Department of Medicine, Division of Hematology, Duke University Medical Center, Durham, NC, USA
N Engl J Med 355:809-17. 2006 - Management of lepirudin therapy for a patient with antiphospholipid antibody syndrome using the whole blood ecarin clot time and activated partial thromboplastin timeStephanie L Perry
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Blood Coagul Fibrinolysis 14:601-4. 2003..Four patients had normalization of the aPTT, suggesting that a subset of patients with APS may benefit from the TAS aPTT assay when monitoring heparin or other anticoagulation therapy... - Blockade of tissue factor-factor X binding attenuates sepsis-induced respiratory and renal failureKaren E Welty-Wolf
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Am J Physiol Lung Cell Mol Physiol 290:L21-31. 2006..Blockade of factor X binding to the tissue factor-factor VIIa complex attenuates lung and organ injuries in established E. coli sepsis by attenuating the neutrophilic response and inflammatory pathways... 
Plasmapheresis and heparin reexposure as a management strategy for cardiac surgical patients with heparin-induced thrombocytopeniaIan J Welsby
Department of Anesthesiology, Duke University Medical Center, DUMC Box 3094, Durham, NC 27710, USA
Anesth Analg 110:30-5. 2010..Alternative anticoagulants are available, but there are concerns about dosing, efficacy, monitoring, thrombosis, and hemorrhage...- Thrombosis, thrombophilia, and thromboprophylaxis in pregnancyAndra H James
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA
Clin Adv Hematol Oncol 3:187-97. 2005..The risk of thrombosis is higher postpartum than during pregnancy, so anticoagulation therapy is usually continued for at least 6 weeks after delivery... - Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart diseaseWei Jiang
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
J Am Coll Cardiol 61:714-22. 2013..The goal of this study was to evaluate the prevalence and clinical characteristics of mental stress-induced myocardial ischemia... - Point-of-care testing of the international normalized ratio in patients with antiphospholipid antibodiesStephanie L Perry
Division of Hematology, Department of Medicine, Department of Pathology, Duke University Health System, Durham, North Carolina 27710, USA
Thromb Haemost 94:1196-202. 2005..For this subset of APS patients, we suggest using an alternative method to monitor warfarin... - Direct-to-patient expert system and home INR monitoring improves control of oral anticoagulationSusan I O'Shea
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
J Thromb Thrombolysis 26:14-21. 2008.... - Validation of the high-dose heparin confirmatory step for the diagnosis of heparin-induced thrombocytopeniaNicole L Whitlatch
Divisions of Hematology, Duke University Medical Center, Durham, NC 27710, USA
Blood 116:1761-6. 2010..On the basis of data from the heparin/PF4 enzyme-linked immunosorbent assay and confirmatory assays, a predictive computer algorithm could distinguish patients likely to have HIT from those who do not... - Prothrombin and beta 2-glycoprotein I frequently contribute to antiphospholipid antibody interactions with phospholipids and the generation of abnormal waveform profiles in coagulation assaysZuowei Su
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, N.C. 27710, USA
Thromb Haemost 90:218-26. 2003..In conclusion, these results showed that the interactions of IgG with phospholipids via beta(2) GPI or prothrombin constitute the core mechanisms of the abnormal waveforms... - Heparin-induced thrombocytopenia in left ventricular assist device bridge-to-transplant patientsJacob N Schroder
Department of Surgery, Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina 27703, USA
Ann Thorac Surg 84:841-5; discussion 845-6. 2007..Owing to this concern, we compared outcomes of HIT-positive versus control bridge-to-transplantation VAD patients; both groups were reexposed to heparin for cardiopulmonary bypass during transplant... - Time-dependent changes in non-COX-1-dependent platelet function with daily aspirin therapyDeepak Voora
Institute for Genome Sciences and Policy, Duke University, 905 S Lasalle Dr, DUMC Box 3445, Durham, NC 27710, USA
J Thromb Thrombolysis 33:246-57. 2012..Despite suppression of COX-1 activity, NCDPF during aspirin therapy is predictably dynamic: those with heightened NCDPF continue to decline whereas those with low/normal NCDPF return to pre-aspirin levels over time... - Hypercoagulable states and antithrombotic strategies in recurrent vascular access site thrombosisSusan I O'Shea
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
J Vasc Surg 38:541-8. 2003..Prospective studies are needed to evaluate the role and safety of antithrombotic agents in improving vascular access graft patency... - A multi-dose pharmacokinetic study of dalteparin in haemodialysis patientsStephanie L Perry
Hemostasis and Thrombosis Center, Duke University Health System, Box 3422, Room 0563, Stead Building, Durham, NC 27710, USA
Thromb Haemost 96:750-5. 2006..Future studies to evaluate the PK parameters of dalteparin in patients receiving chronic HD may have to use weight-based dosing and will need to be performed over a longer period of time... - Hemostatic activation in a chemically induced rat model of severe hemolysis and thrombosisDeborah A Lewis
Hemostasis and Thrombosis Center, Department of Medicine, Duke University Medical Center, Duke University Health System, Box 3422 Durham, NC 27710, USA
Thromb Res 118:747-53. 2006.... - Heparin modifies the immunogenicity of positively charged proteinsShalini L Chudasama
Division of Hematology, Duke University Medical Center, Durham, NC 27710, USA
Blood 116:6046-53. 2010.... - Comparative effectiveness of warfarin and new oral anticoagulants for the management of atrial fibrillation and venous thromboembolism: a systematic reviewSoheir S Adam
Duke University Medical Center, Department of Medicine, Box 3939, Durham, NC 27710, USA
Ann Intern Med 157:796-807. 2012..New oral anticoagulants (NOACs), including direct thrombin inhibitors (DTIs) and factor Xa (FXa) inhibitors, are emerging alternatives for prophylaxis and treatment of atrial fibrillation (AF) and venous thromboembolism (VTE)... - The kaolin-activated Thrombelastograph predicts bleeding after cardiac surgeryIan J Welsby
Department of Anesthesiology, Division of Cardiothoracic Anesthesia and Critical Care Medicine, Duke University Medical Center, Durham, NC 27710, USA
J Cardiothorac Vasc Anesth 20:531-5. 2006.... - The effect of aspirin on endothelial progenitor cell biology: preliminary investigation of novel propertiesJunyang Lou
Department of Medicine, Division of Cardiology, Duke Clinical Research Institute, Durham, NC 27705, USA
Thromb Res 126:e175-9. 2010..We tested the hypothesis that the nonselective cyclooxygenase (COX) inhibitor aspirin (ASA) exerts an effect on circulating EPCs... - Whole blood gene expression analyses in patients with single versus recurrent venous thromboembolismDeborah A Lewis
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Thromb Res 128:536-40. 2011..Identification of patients at risk for recurrent venous thromboembolism would facilitate decisions concerning the duration of anticoagulant therapy... - Antiphospholipid syndrome: laboratory testing and diagnostic strategiesThomas L Ortel
Division of Hematology, Duke University Medical Center, Durham, North Carolina, USA
Am J Hematol 87:S75-81. 2012..New tests and diagnostic strategies are in various stages of development and should help improve our ability to accurately diagnose this important clinical disorder... - Impact of venous thromboembolism and anticoagulation on cancer and cancer survivalNicole M Kuderer
Division of Hematology, Oncology and Cellular Therapy, Duke Comprehensive Cancer Center, Duke University Medical Center, DUMC 3841, Durham, NC 27710, USA
J Clin Oncol 27:4902-11. 2009..Although the LMWHs and related agents hold promise for improving outcomes in patients with cancer, additional studies of their efficacy and safety in this setting are needed... - Low-molecular-weight heparin for thromboprophylaxis in pregnant women with mechanical heart valvesAndra H James
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA
J Matern Fetal Neonatal Med 19:543-9. 2006..Unfortunately, fatal thromboses have occurred with low-molecular-weight heparin as well... - Antihuman factor V antibodies after use of relatively pure bovine thrombinJeffrey H Lawson
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
Ann Thorac Surg 79:1037-8. 2005..This report calls into question the safety of even relatively pure bovine thrombin... - Cardiolipin polyspecific autoreactivity in two broadly neutralizing HIV-1 antibodiesBarton F Haynes
Duke University School of Medicine, Durham, NC 27710, USA
Science 308:1906-8. 2005..These results may have important implications for generating effective neutralizing antibody responses by using HIV-1 vaccines... - Heparin-induced thrombocytopeniaGowthami M Arepally
Division of Hematology, Duke University Medical Center, Durham, North Carolina 27710, USA
Annu Rev Med 61:77-90. 2010..This review summarizes our current understanding of the pathogenesis, clinical features, diagnostic criteria, and management approaches in HIT... - Influence of sample collection and storage on the detection of platelet factor 4-heparin antibodiesElizabeth F Krakow
Department of Medicine, Duke University Medical Center, Durham, NC, USA
Am J Clin Pathol 128:150-5. 2007..These findings suggest that PF4-heparin antibodies are largely insensitive to the effects of sample preparation and storage... - Invited commentaryIan J Welsby
Department of Anesthesiology, Duke University Medical Center, Room 3409A, DUMC Box 3094, Erwin Rd, Durham, NC 27710, USA
Ann Thorac Surg 84:168-9. 2007 - Gene-expression patterns predict phenotypes of immune-mediated thrombosisAnil Potti
Department of Medicine, Duke University Medical Center, Box 3841 Red Zone, Durham, NC 27710, USA
Blood 107:1391-6. 2006.... - Anti-beta(2)-glycoprotein I antibody-mediated inhibition of activated protein C requires binding of beta(2)-glycoprotein I to phospholipidsTomonori Izumi
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Thromb Haemost 88:620-6. 2002..This study confirms that anti-beta(2)GPI antibodies from APS patients inhibit APC activity, and demonstrates the requirement of phospholipid binding of beta(2)GPI for expression of the inhibitory activity of these antibodies... - Alternative methods of anticoagulation for dialysis-dependent patients with heparin-induced thrombocytopeniaSusan I O'Shea
Divisions of Hematology and Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Semin Dial 16:61-7. 2003..In this report the currently available alternatives to heparin for dialysis, including dosing and monitoring recommendations, are reviewed... - Blockade of tissue factor: treatment for organ injury in established sepsisMartha Sue Carraway
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Am J Respir Crit Care Med 167:1200-9. 2003..These results show that blockade of coagulation attenuates acute lung and renal injury in established Gram-negative sepsis accompanied by antiinflammatory effects of therapy... - Clinical causes and treatment of the thrombotic stormThomas L Ortel
Hemostasis and Thrombosis Center, Duke University Medical Center, Durham, NC 27710, USA
Expert Rev Hematol 5:653-9. 2012..Ongoing studies are focused on identifying underlying genetic factors that may predispose patients to develop this extreme clinical phenotype... - Perioperative management of patients on chronic antithrombotic therapyThomas L Ortel
Hemostasis and Thrombosis Center, Duke University Medical Center, Durham, NC 27710, USA
Blood 120:4699-705. 2012.... - Heparin-induced thrombocytopenia in cancerBenjamin J Miriovsky
Divisions of Hematology, Medical Oncology, and Cellular Therapy, Duke University Medical Center, Durham, North Carolina, USA
J Natl Compr Canc Netw 9:781-7. 2011..Additionally, thrombocytopenia is a common finding in cancer patients. The convergence of these variables highlights the importance of an increased understanding of the disease in cancer patients... - Associations of depressive symptoms, trait hostility, and gender with C-reactive protein and interleukin-6 response after emotion recallBeverly H Brummett
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
Psychosom Med 72:333-9. 2010..Depressive symptoms moderate the effect of trait hostility on circulating levels of CRP and IL-6... - Heparin-induced thrombocytopenia: clinical presentations and therapeutic managementZoë L Larned
Division of Hematology, Duke University Medical Center, Durham, NC 27710, USA
Clin Adv Hematol Oncol 1:356-64. 2003..Complications of HIT can result in significant morbidity and mortality. We review the clinical presentations of HIT, laboratory and diagnostic workup, and treatment agents available or being evaluated... - Frequency of anti-heparin-platelet factor 4 antibodies in hemodialysis patients and correlation with recurrent vascular access thrombosisSusan I O'Shea
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Am J Hematol 69:72-3. 2002..In our study, the presence of anti-PF4/heparin antibodies was rare and was not increased in patients with a history of vascular access thrombosis... - Use of a new platelet function analyzer to detect von Willebrand disease in women with menorrhagiaAndra H James
Department of Obstetrics and Gynecology, Division of Hematology, Duke University Medical Center, Durham, NC, USA
Am J Obstet Gynecol 191:449-55. 2004..The purpose of this study was to assess the usefulness of a new platelet function analyzer in the detection of von Willebrand disease and platelet dysfunction in women with menorrhagia... - Contributions of Asn2198, Met2199, and Phe2200 in the factor VIII C2 domain to cofactor activity, phospholipid-binding, and von Willebrand factor-bindingDeborah A Lewis
Division of Hematology, Duke University Medical Center, Durham, NC 27710, USA
Thromb Haemost 89:795-802. 2003..All mutant proteins were still recognized by a monoclonal antibody and two factor VIII inhibitors that neutralized cofactor activity and blocked factor VIII binding to phospholipids... - Thrombophilias: when should we test and how does it help?Nicole L Whitlatch
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Semin Respir Crit Care Med 29:25-39. 2008.... - Responses of mental stress-induced myocardial ischemia to escitalopram treatment: background, design, and method for the Responses of Mental Stress Induced Myocardial Ischemia to Escitalopram Treatment trialWei Jiang
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
Am Heart J 163:20-6. 2012..Depression is a risk factor of MSIMI. The REMIT trial investigates whether selective serotonin reuptake inhibitor (SSRI) treatment can improve MSIMI. The rationale and outline of the study are described... - Laboratory diagnosis of the lupus anticoagulantThomas L Ortel
Division of Hematology, Duke University Medical Center, Durham, NC 27710, USA
Curr Rheumatol Rep 14:64-70. 2012.... - Preoperative anti-PF4/heparin antibody level predicts adverse outcome after cardiac surgeryElliott Bennett-Guerrero
Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
J Thorac Cardiovasc Surg 130:1567-72. 2005..We sought to determine the association between preoperative serum antibodies directed against platelet factor 4/heparin complexes and major complications (in-hospital death or length of stay >10 days) in adult cardiac surgical patients... - Acquired thrombotic risk factors in the critical care settingThomas L Ortel
Duke Hemostasis and Thrombosis Center, Duke University Medical Center, Durham, NC, USA
Crit Care Med 38:S43-50. 2010..g., a direct thrombin inhibitor) in the acute setting. The duration of anticoagulant therapy would vary depending on the specific clinical setting... - Evolution of adverse changes in stored RBCsElliott Bennett Guerrero
Department of Anesthesiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA
Proc Natl Acad Sci U S A 104:17063-8. 2007.... - Clinical implications for patients on antithrombotic therapy while taking supplementsThomas L Ortel
Medicine and Pathology, Hemostasis and Thrombosis Center, Room 0563 Stead Building, Box 3422 Duke University Medical Center, Durham, NC 27710, USA
Thromb Res 117:75-80; discussion 113-5. 2005 - Thrombophilia and thrombosis in thrombotic thrombocytopenic purpuraAnil Potti
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
Semin Thromb Hemost 31:652-8. 2005.... - Characterization of the hypercoagulable state in patients with sickle cell diseaseNirmish Shah
Division of Hematology Oncology, Department of Pediatrics, Duke University, Durham, NC, USA
Thromb Res 130:e241-5. 2012..The pathophysiology of sickle cell disease (SCD) is complex, with increasing evidence of a pronounced prothrombotic state... - Issues in the utilization of low molecular weight heparinsThomas L Ortel
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Semin Hematol 39:172-8. 2002..Therapeutic monitoring also may be useful for the morbidly obese, in children, and for patients with malignancy... - Coagulation and inflammation in acute lung injuryKaren E Welty-Wolf
Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
Thromb Haemost 88:17-25. 2002.... - Antiphospholipid antibodies after surgical exposure to topical bovine thrombinZuowei Su
Department of Medicine, Division of Hematology, Duke University Medical Center, Durham, NC 27710, USA
J Lab Clin Med 139:349-56. 2002..Nevertheless, our findings support the recommendation that the clinical safety of these commonly used hemostatic agents should be reassessed... - von Willebrand's disease diagnosed after menorrhagia worsened from levonorgestrel intrauterine systemAndrea S Lukes
Department of Obstetrics and Gynecology and Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Obstet Gynecol 105:1223-6. 2005..Adult females with menorrhagia may have unrecognized mild von Willebrand's disease. Most females with known von Willebrand's disease report menorrhagia... - RNA aptamers as reversible antagonists of coagulation factor IXaChristopher P Rusconi
Department of Surgery, Program in Combinatorial Therapeutics, Duke University Medical Center, Durham, North Carolina 27710, USA
Nature 419:90-4. 2002..This generalizable strategy for rationally designing a drug-antidote pair thus opens up the way for developing safer regulatable therapeutics... - Clinical and laboratory evaluation of thrombophiliaStephanie L Perry
Division of Medical Oncology, Division of Hematology, Duke University Medical Center, Trent Drive, Durham, NC 27710, USA
Clin Chest Med 24:153-70. 2003.... - Warfarin in antiphospholipid syndrome--time to explore new horizonsDoruk Erkan
J Rheumatol 32:208-12. 2005 - Coagulation abnormalities in patients with hip osteonecrosisAnastasios V Korompilias
Department of Orthopaedic Surgery, University of Ioannina School of Medicine, Ioannina, 45110, Greece
Orthop Clin North Am 35:265-71, vii. 2004..Early diagnosis of hypercoagulability in the group of patients at risk may allow pharmacologic intervention that may prevent this devastating process from developing... - Antiphospholipid antibodiesStephan Moll
Arch Intern Med 162:1783-4; author reply 1786-7. 2002 - Detection of antibody-mediated reduction of annexin A5 anticoagulant activity in plasmas of patients with the antiphospholipid syndromeJacob H Rand
Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
Blood 104:2783-90. 2004..This "annexin A5 resistance" identifies a novel mechanism for thrombosis in the aPL syndrome... - Age and dose sensitivities in the 2-butoxyethanol F344 rat model of hemolytic anemia and disseminated thrombosisYuval Ramot
Hadassah Medical Center, Hebrew University, Jerusalem, Israel
Exp Toxicol Pathol 58:311-22. 2007..Because our findings show age- and dose-related sensitivities, we suggest that 12-week-old rats and doses of 250 mg/kg be used in the 2-BE model... - Two classes of germline genes both derived from the V(H)1 family direct the formation of human antibodies that recognize distinct antigenic sites in the C2 domain of factor VIIIEdward N van den Brink
Department of Plasma Proteins, CLB, Amsterdam, The Netherlands
Blood 99:2828-34. 2002..Together these data indicate that antibodies assembled from V(H) gene segments DP-5 and the closely related germline gene segments DP-10, DP-14, and DP-88 target 2 distinct antigenic sites in the C2 domain of factor VIII... - Venous thromboembolic disease. Clinical practice guidelines in oncologyLawrence D Wagman
City of Hope Cancer Center, USA
J Natl Compr Canc Netw 4:838-69. 2006 - Dialogue with patient care organizationsRebecca Costello
Office of Dietary Supplements, National Institutes of Health Bethesda, MD 20892, USA
Thromb Res 117:211-22; discussion 223-5. 2005 - A review of the therapeutic uses of thrombinRoger L Lundblad
Department of Pathology, University of North Carolina at Chapel Hill, USA
Thromb Haemost 91:851-60. 2004..However, the availability of a safe human thrombin preparation will be critical for the continued use of thrombin as a therapeutic... - Two mechanistic pathways for thienopyridine-associated thrombotic thrombocytopenic purpura: a report from the SERF-TTP Research Group and the RADAR ProjectCharles L Bennett
VA Center for Management of Complex Chronic Care at Jesse Brown VA Medical Center, Division of Hematology Oncology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA
J Am Coll Cardiol 50:1138-43. 2007..We sought to describe clinical and laboratory findings for a large cohort of patients with thienopyridine-associated thrombotic thrombocytopenic purpura (TTP)...