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1. Bleeding risk in hospitalized patients with COVID‐19 receiving intermediate‐ or therapeutic doses of thromboprophylaxis

Author: Pablo Demelo‐Rodriguez, Ana Isabel Farfán‐Sedano, José María Pedrajas, Pilar Llamas, Patricia Sigüenza, María Jesús Jaras, Manuel Quintana‐Diaz, Carmen Fernández‐Capitán, Behnood Bikdeli, David Jiménez, Manuel Monreal, Adarraga D, Aibar J, Baeza C, Ballaz A, Barba R, Blanco‐Molina A, Botella E, Criado J, Demelo‐Rodríguez P, Díaz‐Brasero AM, de Ancos C, del Toro J, Farfán‐Sedano AI, Fernández‐Capitán C, Fidalgo A, Flores K, Gabara C, Galeano‐Valle F, Gavín‐Sebastián O, Gil‐Díaz A, Jaras MJ, Jara‐Palomares L, Jiménez R, Lainez‐Justo S, Latorre A, Lecumberri R, Llamas P, Lobo JL, López‐Jiménez L, Loureiro B, Madridano O, Mancebo‐Plaza AB, Martín del Pozo M, Monreal M, Muñoz‐Rivas N, Núñez‐Fernández MJ, Olivera PE, Ordieres‐Ortega L, Padín‐Paz EM, Pedrajas JM, Quintana‐Díaz M, Ríos‐Prego M, Rodríguez‐Chiaradía DA, Ruiz‐Artacho P, Sigüenza P, Suriñach JM, Trujillo‐Santos J, Zamora C, Bucherini E, Di Micco P, Imbalzano E, Siniscalchi C, Bosevski M, Stevanovic M, Paz‐Rios L, and Weinberg I
Subjects: anticoagulants, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Hospitalized patients, 030204 cardiovascular system & hematology, Logistic regression, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, COVID‐19, death, Internal medicine, medicine, Humans, Retrospective Studies, SARS-CoV-2, business.industry, Mortality rate, Incidence (epidemiology), Hazard ratio, COVID-19, Venous Thromboembolism, Original Articles, Hematology, Confidence interval, Original Article, prognosis, hemorrhage, business, Cohort study
Abstract: Introduction Some local protocols suggest using intermediate or therapeutic doses of anticoagulants for thromboprophylaxis in hospitalized patients with coronavirus disease 2019 (COVID‐19). However, the incidence of bleeding, predictors of major bleeding, or the association between bleeding and mortality remain largely unknown. Methods We performed a cohort study of patients hospitalized for COVID‐19 that received intermediate or therapeutic doses of anticoagulants from March 25 to July 22, 2020, to identify those at increased risk for major bleeding. We used bivariate and multivariable logistic regression to explore the risk factors associated with major bleeding. Results During the study period, 1965 patients were enrolled. Of them, 1347 (69%) received intermediate‐ and 618 (31%) therapeutic‐dose anticoagulation, with a median duration of 12 days in both groups. During the hospital stay, 112 patients (5.7%) developed major bleeding and 132 (6.7%) had non‐major bleeding. The 30‐day all‐cause mortality rate for major bleeding was 45% (95% confidence interval [CI]: 36%‐54%) and for non‐major bleeding 32% (95% CI: 24%‐40%). Multivariable analysis showed increased risk for in‐hospital major bleeding associated with D‐dimer levels >10 times the upper normal range (hazard ratio [HR], 2.23; 95% CI, 1.38–3.59), ferritin levels >500 ng/ml (HR, 2.01; 95% CI, 1.02–3.95), critical illness (HR, 1.91; 95% CI, 1.14–3.18), and therapeutic‐intensity anticoagulation (HR, 1.43; 95% CI, 1.01–1.97). Conclusions Among patients hospitalized with COVID‐19 receiving intermediate‐ or therapeutic‐intensity anticoagulation, a major bleeding event occurred in 5.7%. Use of therapeutic‐intensity anticoagulation, critical illness, and elevated D‐dimer or ferritin levels at admission were associated with increased risk for major bleeding.
Published: 2021
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2. Edoxaban for the Long‐Term Therapy of Venous Thromboembolism: Should the Criteria for Dose Reduction be Revised?

Author: Camporese, G., Simioni, P., Di Micco, P., Fernandez-Capitan, C., Rivas, A., Font, C., Sahuquillo, J. C., Villares, P., Prandoni, P., Monreal, M., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Arcelus, J. I., Baeza, C., Ballaz, A., Barba, R., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Camon, A. M., Castro, J., Caudevilla, M. A., Cerda, P., Chasco, L., Criado, J., de Ancos, C., de Miguel, J., del Toro, J., Demelo-Rodriguez, P., Diaz-Peromingo, J. A., Diez-Sierra, J., Dominguez, I. M., Encabo, M., Escribano, J. C., Falga, C., Farfan, A. I., Fernandez de Roitegui, K., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Mullor, M. M., Gavin-Blanco, O., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Joya, M. D., Jou, I., Lacruz, B., Lalueza, A., Lecumberri, R., Lima, J., Lobo, J. L., Lopez-Brull, H., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Baquerizo, C., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Munoz-Rivas, N., Nart, E., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Recio, M. D., Osorio, J., Otalora, S., Otero, R., Paredes, D., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Peris, M. L., Pesantez, D., Porras, J. A., Portillo, J., Ramos, E., Reig, L., Riera-Mestre, A., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rogado, J., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Siguenza, P., Sirisi, M., Soler, S., Suarez, S. Surinach J. M., Tiberio, G., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vidal, G., Vilar, C., Zamora, C., Gutierrez, P., Vazquez, F. J., Vanassche, T., Vandenbriele, C., Verhamme, P., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Crichi, B., Debourdeau, P., Espitia, O., Farge-Bancel, D., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., Colaizzo, D., Dentali, F., Giammarino, E., Grandone, E., Mangiacapra, S., Mastroiacovo, D., Maida, R., Mumoli, N., Pace, F., Pesavento, R., Pomero, F., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Make, K., Meilanden, K., Skride, A., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Caprini, J. A., Tafur, A. J., Weinberg, I., Wilkins, H., Bui, H. M., and UAM. Departamento de Medicina
Subjects: Male, medicine.medical_specialty, Time Factors, Dose, Medicina, Pyridines, Hemorrhage, General Biochemistry, Genetics and Molecular Biology, Article, chemistry.chemical_compound, Edoxaban, Recurrence, Internal medicine, medicine, Humans, Prospective Studies, Registries, General Pharmacology, Toxicology and Pharmaceutics, Long term therapy, Aged, Aged, 80 and over, Dose-Response Relationship, Drug, Drug Tapering, business.industry, lcsh:Public aspects of medicine, General Neuroscience, Mortality rate, Research, lcsh:RM1-950, Hazard ratio, Anticoagulants, lcsh:RA1-1270, General Medicine, Articles, Venous Thromboembolism, Middle Aged, Confidence interval, Thiazoles, lcsh:Therapeutics. Pharmacology, chemistry, Practice Guidelines as Topic, Dose reduction, Female, business, Venous thromboembolism, Follow-Up Studies
Abstract: Edoxaban is used for venous thromboembolism (VTE) treatment. Real-life data are lacking about its use in long-term therapy. We aimed to assess the efficacy and the safety of edoxaban for long-term VTE treatment in a real-life setting. Patients with VTE included in the Registro Informatizado Enfermedad TromboEmbólica (RIETE) registry, receiving edoxaban 60 or 30 mg daily were prospectively followed up to validate the benefit of using different dosages. The main outcome was the composite of VTE recurrences or major bleeding in patients with or without criteria for dose reduction. Multivariable analysis to identify predictors for the composite outcome was performed. From October 2015 to November 2019, 562 patients received edoxaban for long-term therapy. Most (94%) of the 416 patients not meeting criteria for dose reduction received 60 mg daily, and 92 patients meeting criteria (63%) received 30 mg daily. During treatment, two patients developed recurrent VTE, six had major bleeding and nine died (2 from fatal bleeding). Among patients not meeting criteria for dose reduction, those receiving 30 mg daily had a higher rate of the composite event (hazard ratio (HR) 8.37; 95% confidence interval (CI) 1.12–42.4) and a significant higher mortality rate (HR 31.1; 95% CI 4.63–262) than those receiving 60 mg. Among patients meeting criteria for dose reduction, those receiving 60 mg daily had no events, and a nonsignificantly higher mortality rate (HR 5.04; 95% CI 0.54–133) than those receiving 30 mg daily. In conclusion, edoxaban seems to be effective and safe for long-term VTE treatment in real life. Criteria for dose reduction should be reformulated., No funding was received for this work
Published: 2020

3. Prognostic impact of acute kidney injury in patients with acute pulmonary embolism data from the RIETE registry

Author: Murgier, M, Bertoletti, L, Bikdeli, B, Jimenez, D, Trujillo-Santos, J, Merah, A, de Ancos, C, Fidalgo, A, Aibar, J, and Monreal, M
Subjects: Pulmonary embolism, Mortality, Prognosis, Acute kidney injury
Abstract: Risk stratification is recommended for patients with pulmonary embolism (PE), and usually starts with the assessment of the hemodynamic status and the simplified Pulmonary Embolism Severity Index (sPESI). The influence of acute kidney injury (AKI) on the prognostic stratification has not been evaluated according to the "Kidney Disease: Improving Global Outcomes" (KDIGO). AKI was computed according to the KDIGO definition in patients with acute PE in the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry. Patients with hemodynamic instability were considered high-risk. Normotensive patients were stratified according to the sPESI score (low-risk: sPESI = 0; intermediate-risk: sPESI > 0). The primary outcome was all-cause 30-day mortality. Secondary outcomes were major bleeding and VTE recurrences during the same period. Among 30,532 patients with PE, 1108 (3.6%) were classified to be at high-risk, 10,577 (34.6%) at low-risk, and the remaining 18,847 (61.8%) at intermediate-risk of adverse events. At baseline, 7879 (26%) had AKI. Overall, 1543 of 30,532 patients (5.1%) died within the first 30 days. The presence of AKI was associated with increased mortality rates in all subgroups of patients: in those at low-risk it increased from 0.46 to 3%, in intermediate-risk from 5.4 to 10%, and in high-risk patients from 9.4 to 18%. The presence of AKI was also associated with an increased risk of major bleeding in all subgroups. The addition of the AKI status to the sPESI score improved the prediction of the 30-day mortality and may be particularly helpful for decisions such as identification of low-risk patient for home discharge.
Published: 2022

4. Efficacy and Safety of Tinzaparin in Prophylactic, Intermediate and Therapeutic Doses in Non-Critically Ill Patients Hospitalized with COVID-19: The PROTHROMCOVID Randomized Controlled Trial

Author: Munoz-Rivas N, Aibar J, Gabara-Xanco C, Trueba-Vicente A, Urbelz-Perez A, Gomez-Del Olmo V, Demelo-Rodriguez P, Rivera-Gallego A, Bosch-Nicolau P, Perez-Pinar M, Rios-Prego M, Madridano-Cobo O, Ramos-Alonso L, Alonso-Carrillo J, Francisco-Albelsa I, Marti-Saez E, Maestre-Peiro A, Mendez-Bailon M, Hernandez-Rivas J, and Torres-Macho J
Subjects: pulmonary embolism, respiratory insufficiency, COVID-19, low-molecular-weight heparin, thrombosis
Abstract: Hospitalized patients with COVID-19 are at increased risk of thrombosis, acute respiratory distress syndrome and death. The optimal dosage of thromboprophylaxis is unknown. The aim was to evaluate the efficacy and safety of tinzaparin in prophylactic, intermediate, and therapeutic doses in non-critical patients admitted for COVID-19 pneumonia. PROTHROMCOVID is a randomized, unblinded, controlled, multicenter trial enrolling non-critical, hospitalized adult patients with COVID-19 pneumonia. Patients were randomized to prophylactic (4500 IU), intermediate (100 IU/kg), or therapeutic (175 IU/kg) groups. All tinzaparin doses were administered once daily during hospitalization, followed by 7 days of prophylactic tinzaparin at discharge. The primary efficacy outcome was a composite endpoint of symptomatic systemic thrombotic events, need for invasive or non-invasive mechanical ventilation, or death within 30 days. The main safety outcome was major bleeding at 30 days. Of the 311 subjects randomized, 300 were included in the prespecified interim analysis (mean [SD] age, 56.7 [14.6] years; males, 182 [60.7%]). The composite endpoint at 30 days from randomization occurred in 58 patients (19.3%) of the total population; 19 (17.1 %) in the prophylactic group, 20 (22.1%) in the intermediate group, and 19 (18.5%) in the therapeutic dose group (p = 0.72). No major bleeding event was reported; non-major bleeding was observed in 3.7% of patients, with no intergroup differences. Due to these results and the futility analysis, the trial was stopped. In non-critically ill COVID-19 patients, intermediate or full-dose tinzaparin compared to standard prophylactic doses did not appear to affect the risk of thrombotic event, non-invasive ventilation, or mechanical ventilation or death. ClinicalTrials.gov Identifier (NCT04730856). Edura-CT registration number: 2020-004279-42.
Published: 2022

5. The melatonin contained in beer can provide health benefits, due to its antioxidant, anti-inflammatory and immunomodulatory properties

Author: Maldonado y Aibar, María Dolores, Romero Aibar, J., Calvo Gutiérrez, Juan Ramón, and Universidad de Sevilla. Departamento de Bioquímica Médica y Biología Molecular e Inmunología
Subjects: Immunomodulation, Mediterranean diet, Beer, Antioxidant, Melatonin
Abstract: Beer is a fermented beverage with a low alcohol content originating from cereal fermentation (barley or wheat). It forms part of the diet for many people. It contains melatonin (N-acetyl-5-methoxytryptamine). Melatonin is a molecule with a wide range of antioxidant, oncostatic, immunomodulatory, and cytoprotective properties. The aim of this work was to review the data supporting the idea that a moderate consumption of beer, because of its melatonin content, is particularly useful in healthy diets and in other physiological situations (such as pregnancy, menopause, and old age). Data source: a) The MEDLINE /PubMed search was conducted from 1975 to April 2022, and b) Our own experience and published studies on melatonin, the immune system, and beer. We provide a review of research on the mechanisms of melatonin generation in beer, its concentrations, and its possible effects on health. The melatonin contained in beer, as part of a healthy diet and in some special physiological situations, could act as a protective factor and improve the quality of life of those who drink it in moderation. Ministerio de Economía BFU2017-85832-R
Published: 2022

6. Liver status and outcomes in patients without previous known liver disease receiving anticoagulant therapy for venous thromboembolism

Author: Martinez-Urbistondo D., de la Garza R. G., Villares-Fernandez P., Font C., Schellong S., Lopez-Nunez J. J., Gil-Diaz A., del Carmen Diaz-Pedroche M., Hirmerova J., Monreal M., Adarraga M., Aibar J., Alonso J., Amado C., Arcelus J., Asuero A., Ballaz A., Barba R., Barbagelata C., Barron M., Barron-Andres B., Blanco-Molina A., Beddar Chaib F., Botella E., Castro J., Chasco L., Criado J., de Ancos C., del Toro J., Demelo-Rodriguez P., Diaz-Brasero A., Diaz-Pedroche M., Diaz-Peromingo J., Di Campli M., Dubois-Silva A., Escribano J., Esposito F., Farfan-Sedano A., Fernandez-Capitan C., Fernandez-Reyes J., Fidalgo M., Flores K., Font L., Francisco I., Gabara C., Galeano-Valle F., Garcia M., Garcia-Bragado F., Garcia de Herreros M., de la Garza R., Garcia-Diaz C., Gomez-Cuervo C., Grau E., Guirado L., Gutierrez J., Hernandez-Blasco L., Jara-Palomares L., Jaras M., Jimenez D., Jimenez R., Jimenez-Alfaro C., Joya M., Lainez-Justo S., Lalueza A., Latorre A., Lima J., Lobo J., Lopez-Jimenez L., Lopez-Miguel P., Lopez-Nunez J., Lopez-Reyes R., Lopez-Saez J., Lorenzo A., Madridano O., Maestre A., Marchena P., Martin del Pozo M., Martin-Martos F., Mella C., Mercado M., Moises J., Munoz-Blanco A., Nieto J., Nofuentes-Perez E., Nunez-Fernandez M., Olid-Velilla M., Olivares M., Osorio J., Otalora S., Otero R., Paredes D., Pedrajas J., Porras J., Portillo J., Redondo I., Rodriguez-Matute C., Rosa V., Ruiz-Artacho P., Ruiz-Ruiz J., Salgueiro G., Sanchez-Martinez R., Sanchez-Munoz-Torrero J., Sancho T., Soler S., Suarez-Rodriguez B., Surinach J., Torres M., Torres-Sanchez A., Tolosa C., Trujillo-Santos J., Uresandi F., Valero B., Valle R., Varona J., Vela L., Vela J., Vidal G., Villalobos A., Villares P., Zamora C., Ay C., Nopp S., Pabinger I., Engelen M., Vanassche T., Verhamme P., Maly R., Accassat S., Ait Abdallah N., Bertoletti L., Bura-Riviere A., Catella J., Couturaud F., Crichi B., Debourdeau P., Espitia O., Farge-Bancel D., Grange C., Helfer H., Lacut K., Le Mao R., Mahe I., Morange P., Moustafa F., Poenou G., Sarlon-Bartoli G., Suchon P., Quere I., Braester A., Brenner B., Kenet G., Tzoran I., Basaglia M., Bilora F., Bortoluzzi C., Brandolin B., Ciammaichella M., De Angelis A., Di Micco P., Imbalzano E., Merla S., Pesavento R., Prandoni P., Siniscalchi C., Tufano A., Visona A., Vo Hong N., Zalunardo B., Nishimoto Y., Sato Y., Make K., Skride A., Strautmane S., Fonseca S., Martins F., Meireles J., Bosevski M., Bounameaux H., Mazzolai L., Caprini J., Bui H., Martinez-Urbistondo, D., de la Garza, R. G., Villares-Fernandez, P., Font, C., Schellong, S., Lopez-Nunez, J. J., Gil-Diaz, A., del Carmen Diaz-Pedroche, M., Hirmerova, J., Monreal, M., Adarraga, M., Aibar, J., Alonso, J., Amado, C., Arcelus, J., Asuero, A., Ballaz, A., Barba, R., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Beddar Chaib, F., Botella, E., Castro, J., Chasco, L., Criado, J., de Ancos, C., del Toro, J., Demelo-Rodriguez, P., Diaz-Brasero, A., Diaz-Pedroche, M., Diaz-Peromingo, J., Di Campli, M., Dubois-Silva, A., Escribano, J., Esposito, F., Farfan-Sedano, A., Fernandez-Capitan, C., Fernandez-Reyes, J., Fidalgo, M., Flores, K., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M., Garcia-Bragado, F., Garcia de Herreros, M., de la Garza, R., Garcia-Diaz, C., Gomez-Cuervo, C., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M., Jimenez, D., Jimenez, R., Jimenez-Alfaro, C., Joya, M., Lainez-Justo, S., Lalueza, A., Latorre, A., Lima, J., Lobo, J., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J., Lopez-Reyes, R., Lopez-Saez, J., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P., Martin del Pozo, M., Martin-Martos, F., Mella, C., Mercado, M., Moises, J., Munoz-Blanco, A., Nieto, J., Nofuentes-Perez, E., Nunez-Fernandez, M., Olid-Velilla, M., Olivares, M., Osorio, J., Otalora, S., Otero, R., Paredes, D., Pedrajas, J., Porras, J., Portillo, J., Redondo, I., Rodriguez-Matute, C., Rosa, V., Ruiz-Artacho, P., Ruiz-Ruiz, J., Salgueiro, G., Sanchez-Martinez, R., Sanchez-Munoz-Torrero, J., Sancho, T., Soler, S., Suarez-Rodriguez, B., Surinach, J., Torres, M., Torres-Sanchez, A., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Varona, J., Vela, L., Vela, J., Vidal, G., Villalobos, A., Villares, P., Zamora, C., Ay, C., Nopp, S., Pabinger, I., Engelen, M., Vanassche, T., Verhamme, P., Maly, R., Accassat, S., Ait Abdallah, N., Bertoletti, L., Bura-Riviere, A., Catella, J., Couturaud, F., Crichi, B., Debourdeau, P., Espitia, O., Farge-Bancel, D., Grange, C., Helfer, H., Lacut, K., Le Mao, R., Mahe, I., Morange, P., Moustafa, F., Poenou, G., Sarlon-Bartoli, G., Suchon, P., Quere, I., Braester, A., Brenner, B., Kenet, G., Tzoran, I., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., De Angelis, A., Di Micco, P., Imbalzano, E., Merla, S., Pesavento, R., Prandoni, P., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Nishimoto, Y., Sato, Y., Make, K., Skride, A., Strautmane, S., Fonseca, S., Martins, F., Meireles, J., Bosevski, M., Bounameaux, H., Mazzolai, L., Caprini, J., and Bui, H.
Subjects: medicine.medical_specialty, VTE risk assessment, Healthy individual, Elevated liver enzymes, Hemorrhage, Gastroenterology, Liver disease, Recurrence, Fibrosis, Internal medicine, Internal Medicine, medicine, Anticoagulation adverse event, Humans, In patient, Registries, Clinical VTE, business.industry, Liver Diseases, Anticoagulants, Venous Thromboembolism, medicine.disease, Im - Original, Non-invasive liver assessment, Healthy individuals, Increased risk, Anticoagulant therapy, Emergency Medicine, Anticoagulation adverse events, business, Venous thromboembolism, Major bleeding
Abstract: The association between elevated liver enzymes or FIB-4 (fibrosis index 4) and outcome in patients with venous thromboembolism (VTE) has not been evaluated. Data from patients in RIETE (Registro Informatizado Enfermedad TromboEmbólica) were used to assess the association between elevated liver enzymes or FIB-4 levels and the rates of major bleeding or death in apparent liver disease-free patients with acute VTE under anticoagulation therapy. A total of 6206 patients with acute VTE and without liver disease were included. Of them, 92 patients had major bleeding and 168 died under anticoagulation therapy. On multivariable analysis, patients with elevated liver enzymes were at increased mortality risk (HR: 1.58; 95% CI: 1.10–2.28), while those with FIB-4 levels > 2.67 points were at increased risk for major bleeding (HR: 1.69; 95% CI: 1.04–2.74). Evaluation of liver enzymes and FIB-4 index at baseline in liver disease-free patients with VTE may provide additional information on the risk for major bleeding or death during anticoagulation. Supplementary Information The online version contains supplementary material available at 10.1007/s11739-021-02858-x.
Published: 2021

7. Real-Time Dissemination of Aggregate Data on Presentation and Outcomes of Patients With Venous Thromboembolism: The RIETE Infographics Project

Author: Tafur, A., Bikdeli, B., Weinberg, I., Jimenez, D., Monreal, A., Barba, R., Mira, E., Macrinici, V., Krumholz, H. M., Hawkins, M., Monreal, M., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Arcelus, J. I., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Camon, A. M., Canas, I., Castro, J., Cerda, P., Criado, J., de Ancos, C., de Miguel, J., del Toro, J., Demelo-Rodriguez, P., Diaz-Peromingo, J. A., Diez-Sierra, J., Diaz-Simon, R., Dominguez, I. M., Encabo, M., Escribano, J. C., Falga, C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Mullor, M. M., Gavin-Blanco, O., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Joya, M. D., Jou, I., Lacruz, B., Lecumberri, R., Lima, J., Lobo, J. L., Lopez-Brull, H., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Guerra, J. M., Martin-Martos, F., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Michel, C., Ortega-Recio, M. D., Osorio, J., Otero, R., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Perez-Jacoiste, A., Peris, M. L., Pesantez, D., Porras, J. A., Ramos, E., Reig, L., Riera-Mestre, A., Rivas, A., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Suarez, S., Surinach, J. M., Tiberio, G., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vidal, G., Villares, P., Zamora, C., Gutierrez, P., Vazquez, F. J., Vanassche, T., Vandenbriele, C., Verhamme, P., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Crichi, B., Debourdeau, P., Espitia, O., Farge-Bancel, D., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Giammarino, E., Grandone, E., Mangiacapra, S., Mastroiacovo, D., Maida, R., Mumoli, N., Pace, F., Pesavento, R., Pomero, F., Prandoni, P., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Gibietis, V., Kigitovica, D., Skride, A., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Caprini, J. A., Tafur, A. J., Wilkins, H., Bui, H. M., Tafur, A., Bikdeli, B., Weinberg, I., Jimenez, D., Monreal, A., Barba, R., Mira, E., Macrinici, V., Krumholz, H. M., Hawkins, M., Monreal, M., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Arcelus, J. I., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Camon, A. M., Canas, I., Castro, J., Cerda, P., Criado, J., de Ancos, C., de Miguel, J., del Toro, J., Demelo-Rodriguez, P., Diaz-Peromingo, J. A., Diez-Sierra, J., Diaz-Simon, R., Dominguez, I. M., Encabo, M., Escribano, J. C., Falga, C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Mullor, M. M., Gavin-Blanco, O., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Joya, M. D., Jou, I., Lacruz, B., Lecumberri, R., Lima, J., Lobo, J. L., Lopez-Brull, H., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Guerra, J. M., Martin-Martos, F., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Michel, C., Ortega-Recio, M. D., Osorio, J., Otero, R., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Perez-Jacoiste, A., Peris, M. L., Pesantez, D., Porras, J. A., Ramos, E., Reig, L., Riera-Mestre, A., Rivas, A., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Suarez, S., Surinach, J. M., Tiberio, G., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vidal, G., Villares, P., Zamora, C., Gutierrez, P., Vazquez, F. J., Vanassche, T., Vandenbriele, C., Verhamme, P., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Crichi, B., Debourdeau, P., Espitia, O., Farge-Bancel, D., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Colaizzo, D., Dentali, F., Di Micco, P., Giammarino, E., Grandone, E., Mangiacapra, S., Mastroiacovo, D., Maida, R., Mumoli, N., Pace, F., Pesavento, R., Pomero, F., Prandoni, P., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Gibietis, V., Kigitovica, D., Skride, A., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Caprini, J. A., Tafur, A. J., Wilkins, H., and Bui, H. M.
Subjects: Male, 0301 basic medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, pulmonary embolism, Patient Empowerment, media_common.quotation_subject, 030204 cardiovascular system & hematology, Data Aggregation, 03 medical and health sciences, Presentation, 0302 clinical medicine, thrombosis, pulmonary embolism, risk assessment, Humans, Medicine, Prospective Studies, Registries, cardiovascular diseases, thrombosis, media_common, business.industry, Infographic, risk assessment, Venous Thromboembolism, Hematology, General Medicine, Precision medicine, medicine.disease, Treatment Outcome, 030104 developmental biology, lcsh:RC666-701, Female, Original Article, Aggregate data, Medical emergency, business, Risk assessment, Venous thromboembolism
Abstract: In the current era of patient empowerment and precision medicine, access to timely information is critical to decision-making. Unfortunately, we currently lack patient-specific, real-time data about clinical presentation, risk of thrombotic or hemorrhagic events, key risk factors, and adverse outcomes in patients with venous thromboembolism (VTE). Accordingly, the Registro Informatizado Enfermedad TromboEmbólica (RIETE) investigators developed a tool to provide an open-source, real-time graphic representation of VTE-related data derived from over 90 000 patients with confirmed VTE. This information is intended to facilitate discussion in the informed decision-making process. The current article describes the aims, rationale, methods, and ongoing and future efforts of the real-time VTE infographics developed by the RIETE registry collaborators.
Published: 2020

8. D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry

Author: Avnery, O., Martin, M., Bura-Riviere, A., Barillari, G., Mazzolai, L., Mahe, I., Marchena, P. J., Verhamme, P., Monreal, M., Ellis, M. H., Adarraga, M. D., Aibar, M. A., Aibar, J., Amado, C., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Ina, A., Camon, A. M., Canas, I., Carrasco, C., Castro, J., de Ancos, C., del Toro, J., Demelo, P., Diaz-Peromingo, J. A., Falga, C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Criado, M. C., Fernandez-Nunez, S., Fidalgo, M. A., Font, C., Font, L., Freire, M., Gallego, M., Garcia, M. A., Garcia-Bragado, F., Garcia-Morillo, M., Garcia-Raso, A., Gavin, O., Gayol, M. C., Gil-Diaz, A., Gomez, V., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L. M., Iglesias, M., Jara-Palomares, L., Jaras, M. J., Jimenez, R., Jimenez-Castro, D., Jimenez-Lopez, J., Joya, M. D., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Martin del Pozo, M., Martin-Guerra, J. M., Martin-Romero, M., Mellado, M., Morales, M. V., Munoz, N., Nieto-Cabrera, M. A., Nieto-Rodriguez, J. A., Nunez-Ares, A., Nunez, M. J., Olivares, M. C., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Perez-Rus, G., Peris, M. L., Porras, J. A., Rivas, A., Rodriguez-Davila, M. A., Rodriguez-Hernandez, A., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Torregrosa, P., Ruiz-Sada, P., Sahuquillo, J. C., Salazar, V., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Sopena, B., Surinach, J. M., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Valle, R., Vidal, G., Villares, P., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Debourdeau, P., Farge-Bancel, D., Hij, A., Moustafa, F., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Sharif-Kashani, B., Bilora, F., Bortoluzzi, C., Bucherini, E., Ciammaichella, M., Dentali, F., Di Micco, P., Di Pangrazio, M., Maida, R., Mastroiacovo, D., Pace, F., Pallotti, G., Parisi, R., Pesavento, R., Prandoni, P., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Gibietis, V., Skride, A., Strautmane, S., Bosevski, M., Zdraveska, M., Bounameaux, H., Fresa, M., Ney, B., Caprini, J., Bui, H. M., Pham, K. Q., Avnery, O., Martin, M., Bura-Riviere, A., Barillari, G., Mazzolai, L., Mahe, I., Marchena, P. J., Verhamme, P., Monreal, M., Ellis, M. H., Adarraga, M. D., Aibar, M. A., Aibar, J., Amado, C., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Ina, A., Camon, A. M., Canas, I., Carrasco, C., Castro, J., de Ancos, C., del Toro, J., Demelo, P., Diaz-Peromingo, J. A., Falga, C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Criado, M. C., Fernandez-Nunez, S., Fidalgo, M. A., Font, C., Font, L., Freire, M., Gallego, M., Garcia, M. A., Garcia-Bragado, F., Garcia-Morillo, M., Garcia-Raso, A., Gavin, O., Gayol, M. C., Gil-Diaz, A., Gomez, V., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L. M., Iglesias, M., Jara-Palomares, L., Jaras, M. J., Jimenez, R., Jimenez-Castro, D., Jimenez-Lopez, J., Joya, M. D., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Martin del Pozo, M., Martin-Guerra, J. M., Martin-Romero, M., Mellado, M., Morales, M. V., Munoz, N., Nieto-Cabrera, M. A., Nieto-Rodriguez, J. A., Nunez-Ares, A., Nunez, M. J., Olivares, M. C., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Perez-Rus, G., Peris, M. L., Porras, J. A., Rivas, A., Rodriguez-Davila, M. A., Rodriguez-Hernandez, A., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Torregrosa, P., Ruiz-Sada, P., Sahuquillo, J. C., Salazar, V., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Sopena, B., Surinach, J. M., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Valle, R., Vidal, G., Villares, P., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Debourdeau, P., Farge-Bancel, D., Hij, A., Moustafa, F., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Sharif-Kashani, B., Bilora, F., Bortoluzzi, C., Bucherini, E., Ciammaichella, M., Dentali, F., Di Micco, P., Di Pangrazio, M., Maida, R., Mastroiacovo, D., Pace, F., Pallotti, G., Parisi, R., Pesavento, R., Prandoni, P., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Gibietis, V., Skride, A., Strautmane, S., Bosevski, M., Zdraveska, M., Bounameaux, H., Fresa, M., Ney, B., Caprini, J., Bui, H. M., and Pham, K. Q.
Subjects: 0301 basic medicine, Male, Registrie, Multivariate analysis, Enfermedad cardiovascular, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Recurrence, Tromboembolia, Age Factor, Registries, venous thromboembolism recurrence, d-dimer, Hazard ratio, Age Factors, Venous Thromboembolism, Middle Aged, Prognosis, provoked venous thromboembolism, Proteínas, Female, Human, medicine.medical_specialty, Prognosi, Cardiología, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Internal medicine, D-dimer, Internal Medicine, medicine, Humans, In patient, Risk factor, Sistema cardiovascular, Pregnancy, business.industry, Risk Factor, Anticoagulant, Anticoagulants, medicine.disease, 030104 developmental biology, Increased risk, Proteína, business, Venous thromboembolism, Fibrin Fibrinogen Degradation Product
Abstract: Background Patients with venous thromboembolism (VTE) secondary to transient risk factors may develop VTE recurrences after discontinuing anticoagulation. Identifying at‐risk patients could help to guide the duration of therapy. Methods We used the RIETE database to assess the prognostic value of d‐dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel). Results In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d‐dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19–9.57) events per 100 patient‐years in those with raised d‐dimer levels and 2.68 (95% CI: 1.45–4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71–10.4) and 3.34 (95% CI: 2.39–4.53), respectively. Patients with major risk factors and raised d‐dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96–4.79) than those with normal levels. Patients with minor risk factors and raised d‐dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51–3.63) than those with normal levels. On multivariate analysis, raised d‐dimers (HR: 1.74; 95% CI: 1.09–2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors. Conclusions Patients with raised d‐dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences. Sin financiación 8.989 JCR (2020) Q1, 12/167 Medicine, General & Internal 2.625 SJR (2020) Q1, 9/131 Internal Medicine No data IDR 2020 UEM
Published: 2020

9. Herpesviruses and coronavirus infection

Author: Maldonado, María Dolores, Romero-Aibar, J., Pérez-San-Gregorio, M. A., Universidad de Sevilla, Ministerio de Ciencia, Innovación y Universidades (España), Agencia Estatal de Investigación (España), Maldonado, María Dolores [0000-0003-1375-447X], and Maldonado, María Dolores
Subjects: Immune system, Herpes infections, SARS-CoV-2, viruses, COVID-19, Psychoneuroimmunology
Abstract: The appearance on the skin of herpes virus lesions, concomitantly with the COVID-19 pandemic, leads us to suspect an underlying infection with SARS-CoV-2. Diagnostic RT-PCR tests and IgM and IgG seroconversion studies have therefore been carried out. We present three cases of herpes virus infections in immunocompetent patients: one of the infections was herpes simplex 1 in a 40-year-old woman, and the other two were herpes varicella-zoster infections in a 62-year-old man and a 25-year-old woman. The patients were in the care of the southern health district of Seville of the SAS (Andalusian Health Service) during the Spanish state of alarm over the COVID-19 pandemic. The SARS-CoV-2 infection was confirmed in only one of the three cases. In this work, we briefly review the etiopathogenic role of the COVID-19 pandemic situation, whereby immunodeficiencies are generated that favour the appearance of other viral infections, such as herpes virus infections., This work was supported by Seville University (Immunology area), Department of Medical Biochemistry, Molecular Biology, and Immunology; Also, by the Ministry of Economy, Industry and Competitiveness (MINECO 2017), Reference: BFU2017- 85832-R.
Published: 2021

10. Ventilation/perfusion (V/Q) scanning in contemporary patients with pulmonary embolism: utilization rates and predictors of use in a multinational study

Author: Bonnefoy, PB, Prevot, N, Mehdipoor, G, Sanchez, A, Lima, J, Font, L, Gil-Diaz, A, Llamas, P, Aibar, J, Bikdeli, B, Bertoletti, L, and Monreal, M
Subjects: V/Q scan, Radionuclide imaging, Pulmonary embolism, Computed tomography angiography, Q scan
Abstract: Ventilation/perfusion (V/Q) imaging and computed tomography pulmonary angiography (CTPA) are common tools for acute pulmonary embolism (PE) diagnosis. Limited contemporary data exist about the utilization of each modality, including the predictors of using V/Q versus CTPA. We used the data from patients diagnosed with PE using V/Q or CTPA from 2007 to 2019 in Registro Informatizado Enfermedad ThromboEmbolica, an international prospective registry of patients with venous thromboembolism. Outcomes was to determine the trends in utilization of V/Q vs. CTPA and, in a contemporary subgroup fitting with current practices, to evaluate predictors of V/Q use with multivariable logistic regression. Among 26,540 patients with PE, 89.2% were diagnosed with CTPA, 7.1% with V/Q and 3.7% with > 1 thoracic imaging modality. Over time, the proportional use of V/Q scanning declined (13.9 to 3.3%, P < 0.001). In multivariable analysis, heart failure history (odds ratio [OR]:1.5; 95% confidence interval [CI] 1.14-1.98), diabetes ([OR 1.71; 95% CI 1.39-2.10]), moderate and severe renal failure (respectively [OR 1.87; 95% CI 1.47-2.38] and [OR 9.36; 95% CI 6.98-12.55]) were the patient-level predictors of V/Q utilization. We also observed an influence of geographical and institutional factors, partly explained by time-limited V/Q availability (less use over weekends) and regional practices. Use of V/Q for the diagnosis of PE decreased over time, but it still has an important role in specific situations with an influence of patient-related, institution-related and logistical factors. Local and regional resources should be evaluated to improve V/Q accessibility than could benefit for this population.
Published: 2021

11. D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry

Author: Avnery, O, Martin, M, Ellis, MH, Adarraga, MD, Aibar, MA, Aibar, J, Amado, C, Arcelus, JI, Ballaz, A, Barba, R, Barron, M, Barron-Andres, B, Bascunana, J, Blanco-Molina, A, Camon, AM, Canas, I, Carrasco, C, Castro, J, de Ancos, C, del Toro, J, Demelo, P, Diaz-Peromingo, JA, Falga, C, Farfan, AI, Fernandez-Capitan, C, Fernandez-Criado, MC, Fernandez-Nunez, S, Fidalgo, MA, Font, C, Font, L, Freire, M, Gallego, M, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gayol, MC, Gil-Diaz, A, Gomez, V, Gomez-Cuervo, C, Gonzalez-Martinez, J, Grau, E, Gutierrez, J, Hernandez-Blasco, LM, Iglesias, M, Jara-Palomares, L, Jaras, MJ, Jimenez, R, Jimenez-Castro, D, Jimenez-Lopez, J, Joya, MD, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Nunez, JJ, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Madridano, O, Maestre, A, Marchena, PJ, del Pozo, MM, Martin-Guerra, JM, Martin-Romero, M, Mellado, M, Monreal, M, Morales, MV, Munoz, N, Nieto-Cabrera, MA, Nieto-Rodriguez, JA, Nunez-Ares, A, Nunez, MJ, Olivares, MC, Otalora, S, Otero, R, Pedrajas, JM, Pellejero, G, Perez-Rus, G, Peris, ML, Porras, JA, Rivas, A, Rodriguez-Davila, MA, Rodriguez-Hernandez, A, Rubio, CM, Ruiz-Artacho, P, Ruiz-Ruiz, J, Ruiz-Torregrosa, P, Ruiz-Sada, P, Sahuquillo, JC, Salazar, V, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Sopena, B, Surinach, JM, Tolosa, C, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Vidal, G, Villares, P, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Verhamme, P, Hirmerova, J, Maly, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Debourdeau, P, Farge-Bancel, D, Hij, A, Mahe, I, Moustafa, F, Schellong, S, Braester, A, Brenner, B, Ellis, M, Tzoran, I, Sharif-Kashani, B, Barillari, G, Bilora, F, Bortoluzzi, C, Bucherini, E, Ciammaichella, M, Dentali, F, Di Micco, P, Di Pangrazio, M, Maida, R, Mastroiacovo, D, Pace, F, Pallotti, G, Parisi, R, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tufano, A, Visona, A, Hong, NV, Gibietis, VL, Skride, A, Strautmane, S, Bosevski, M, Zdraveska, M, Bounameaux, H, Fresa, M, Mazzolai, L, Ney, B, Caprini, J, Bui, HM, and Pham, KQ
Subjects: venous thromboembolism recurrence, d-dimer, provoked venous thromboembolism
Abstract: Background Patients with venous thromboembolism (VTE) secondary to transient risk factors may develop VTE recurrences after discontinuing anticoagulation. Identifying at-risk patients could help to guide the duration of therapy. Methods We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel). Results In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d-dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19-9.57) events per 100 patient-years in those with raised d-dimer levels and 2.68 (95% CI: 1.45-4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71-10.4) and 3.34 (95% CI: 2.39-4.53), respectively. Patients with major risk factors and raised d-dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96-4.79) than those with normal levels. Patients with minor risk factors and raised d-dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51-3.63) than those with normal levels. On multivariate analysis, raised d-dimers (HR: 1.74; 95% CI: 1.09-2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors. Conclusions Patients with raised d-dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences.
Published: 2020

12. Characteristics, treatment patterns and outcomes of patients presenting with venous thromboembolic events after knee arthroscopy in the RIETE Registry

Author: Weinberg I., Giri J., Kolluri R., Arcelus J. I., Falga C., Soler S., Braester A., Bascunana J., Gutierrez-Guisado J., Monreal M., Adarraga M. D., Agudo P., Aibar M. A., Aibar J., Amado C., Akasbi M., Aranda C., Arenas A., Ballaz A., Barba R., Barron M., Barron-Andres B., Blanco-Molina A., Camon A. M., Carrasco C., Castro J., Cruz A. J., de Ancos C., del Toro J., Demelo P., Diaz-Pedroche M. C., Diaz-Peromingo J. A., Farfan A. I., Fernandez-Capitan C., Fidalgo M. A., Font C., Font L., Garcia M. A., Garcia-Bragado F., Garcia-Morillo M., Garcia-Raso A., Gavin O., Gayol M. C., Gil-Diaz A., Gomez V., Gonzalez-Martinez J., Grau E., Gutierrez J., Hernandez-Blasco L., Iglesias M., Jara-Palomares L., Jaras M. J., Jimenez D., Jou I., Joya M. D., Lalueza A., Lima J., Llamas P., Lobo J. L., Lopez-Jimenez L., Lopez-Miguel P., Lopez-Nunez J. J., Lopez-Reyes R., Lopez-Saez J. B., Lorente M. A., Lorenzo A., Loring M., Loscos S., Lumbierres M., Marchena P. J., Martin-Fernandez M., Martin-Guerra J. M., Martin-Romero M., Mellado M., Modesto M., Morales M. V., Nieto J. A., Nunez A., Nunez M. J., Olivares M. C., Otalora S., Otero R., Pedrajas J. M., Pellejero G., Perez-Jacoiste A., Perez-Rus G., Peris M. L., Pesce M. L., Porras J. A., Rivas A., Rodriguez-Davila M. A., Rodriguez-Fernandez L., Rodriguez-Hernandez A., Rosa V., Rosillo-Hernandez E. M., Rubio C. M., Ruiz-Alcaraz S., Ruiz-Artacho P., Ruiz-Ruiz J., Ruiz-Sada P., Sahuquillo J. C., Samperiz A., Sanchez-Munoz-Torrero J. F., Sancho T., Sanoja I. D., Soto M. J., Surinach J. M., Tapia E., Torres M. I., Trujillo-Santos J., Uresandi F., Usandizaga E., Valle R., Vela J. R., Vilar C., Gutierrez P., Vazquez F. J., Vilaseca A., Vanassche T., Vandenbriele C., Verhamme P., Yoo H. H. B., Hirmerova J., Maly R., Salgado E., Benzidia I., Bertoletti L., Bura-Riviere A., Debourdeau P., Falvo N., Farge-Bancel D., Hij A., Mahe I., Moustafa F., Brenner B., Ellis M., Tzoran I., Barillari G., Bilora F., Bortoluzzi C., Brandolin B., Bucherini E., Camerota A., Ciammaichella M., Dentali F., Di Micco P., Grandone E., Imbalzano E., Lessiani G., Maida R., Mastroiacovo D., Ngoc V., Pace F., Parisi R., Pesavento R., Pinelli M., Prandoni P., Quintavalla R., Rocci A., Siniscalchi C., Sotgiu P., Tufano A., Visona A., Gibietis V., Skride A., Strautmane S., Bosevski M., Zdraveska M., Bounameaux H., Mazzolai L., Caprini J., Bui H. M., Weinberg, I., Giri, J., Kolluri, R., Arcelus, J. I., Falga, C., Soler, S., Braester, A., Bascunana, J., Gutierrez-Guisado, J., Monreal, M., Adarraga, M. D., Agudo, P., Aibar, M. A., Aibar, J., Amado, C., Akasbi, M., Aranda, C., Arenas, A., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Blanco-Molina, A., Camon, A. M., Carrasco, C., Castro, J., Cruz, A. J., de Ancos, C., del Toro, J., Demelo, P., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Farfan, A. I., Fernandez-Capitan, C., Fidalgo, M. A., Font, C., Font, L., Garcia, M. A., Garcia-Bragado, F., Garcia-Morillo, M., Garcia-Raso, A., Gavin, O., Gayol, M. C., Gil-Diaz, A., Gomez, V., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L., Iglesias, M., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jou, I., Joya, M. D., Lalueza, A., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Loscos, S., Lumbierres, M., Marchena, P. J., Martin-Fernandez, M., Martin-Guerra, J. M., Martin-Romero, M., Mellado, M., Modesto, M., Morales, M. V., Nieto, J. A., Nunez, A., Nunez, M. J., Olivares, M. C., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Perez-Jacoiste, A., Perez-Rus, G., Peris, M. L., Pesce, M. L., Porras, J. A., Rivas, A., Rodriguez-Davila, M. A., Rodriguez-Fernandez, L., Rodriguez-Hernandez, A., Rosa, V., Rosillo-Hernandez, E. M., Rubio, C. M., Ruiz-Alcaraz, S., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Sanoja, I. D., Soto, M. J., Surinach, J. M., Tapia, E., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vilar, C., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Verhamme, P., Yoo, H. H. B., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Debourdeau, P., Falvo, N., Farge-Bancel, D., Hij, A., Mahe, I., Moustafa, F., Brenner, B., Ellis, M., Tzoran, I., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Camerota, A., Ciammaichella, M., Dentali, F., Di Micco, P., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Ngoc, V., Pace, F., Parisi, R., Pesavento, R., Pinelli, M., Prandoni, P., Quintavalla, R., Rocci, A., Siniscalchi, C., Sotgiu, P., Tufano, A., Visona, A., Gibietis, V., Skride, A., Strautmane, S., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Caprini, J., Bui, H. M., Vanassche, Thomas, Vandenbriele, Christophe, and Verhamme, Peter
Subjects: Male, medicine.medical_specialty, Knee Joint, Treatment duration, 030204 cardiovascular system & hematology, 03 medical and health sciences, Anticoagulation, Arthroscopy, 0302 clinical medicine, Deep vein thrombosi, Recurrence, Internal medicine, Deep vein thrombosis, medicine, Humans, cardiovascular diseases, Registries, Knee arthroscopy, Aged, Venous Thrombosis, 030222 orthopedics, Hematology, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Incidence, Pulmonary embolism, Venous thromboembolism, Anticoagulants, Female, Middle Aged, Treatment Outcome, Venous Thromboembolism, Small sample, medicine.disease, Orthopedic surgery, Cardiology and Cardiovascular Medicine, business
Abstract: Knee arthroscopy is the most common orthopedic procedure worldwide. While incidence of post-arthroscopy venous thromboembolic events (VTE) is low, treatment patterns and patient outcomes have not been described. Patients from the "Registro Informatizado Enfermedad TromboEmbolica" who had confirmed post-arthroscopy VTE were compared to patients with provoked, post bone-fracture, and to patients with unprovoked VTE. Baseline characteristics, presenting signs and symptoms, treatment and outcomes including recurrent VTE, bleeds or death were compared. A total of 101 patients with post-arthroscopy VTE and 19,218 patients with unprovoked VTE were identified. Post-arthroscopy patients were younger (49.5 vs. 66 years, P
Published: 2018

13. Clinical characteristics and 3-month outcomes in cancer patients with incidental versus clinically suspected and confirmed pulmonary embolism

Author: Peris, M., Lopez-Nunez, J. J., Maestre, A., Jimenez, D., Muriel, A., Bikdeli, B., Weinberg, I., Ay, C., Mazzolai, L., Lorenzo, A., Monreal, M., Monreel, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Verhamme, P., Caprini, J. A., Bui, H. M., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Aramberri, M., Arcelus, J. I., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Camon, A. M., Canas, I., Cerda, P., Criado, J., de Ancos, C., de Miguel, J., del Toro, J., Demelo-Rodriguez, P., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Diez-Sierra, J., Dominguez, I. M., Encabo, M., Escribano, J. C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., de Roitegui, F. K., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Raso, A., Gavin-Blanco, O., Gavin-Sebastian, O., Gayol, M. C., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L., Iglesias, M., Jara-Palomares, L., Jaras, M. J., Joya, M. D., Jou, I., Lacruz, B., Lalueza, A., Lecumberri, R., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Loring, M., Lumbierres, M., Madridano, O., Manrique-Abos, I., Marchena, P. J., Martin-Asenjo, M., Martin-Fernandez, M., Martin-Guerra, J. M., Martin-Martos, F., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Recio, M. D., Osorio, J., Otero, R., Paredes, D., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Perez-Ductor, C., Perez-Jacoiste, M. A., Peris, M. L., Pesantez, D., Porras, J. A., Portillo, J., Ramos, E., Reig, L., Riera-Mestre, A., Rivas, A., Rodriguez-Cobo, A., Rodriguez-Fernandez, L., Rodriguez-Galan, I., Rodriguez-Matute, C., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Ruiz-Torregrosa, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Sanmartin, R., Soler, S., Suarez, S., Surinach, J. M., Tiberio, G., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, Vidal, G., Villares, P., Zamora, C., Gutierrez, P., Vazquez, F. J., Vanassche, T., Vandenbriele, C., Hirmerova, J., Salgado, E., Benzidia, I., Bura-Riviere, A., Crichi, B., Debourdeau, P., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Braester, A., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Colaizzo, D., Dentali, F., Giammarino, E., Grandone, E., Maida, R., Mangiacapra, S., Mastroiacovo, D., Pace, F., Pesavento, R., Pomero, F., Quintavalla, R., Rocci, A., Siniscalchi, C., Tiraferri, E., Tufano, A., Ventresca, A., Visona, A., Vo Hong, N., Zalunardo, B., Kigitovica, D., Make, K., Skride, A., Ferreira, M., Meireles, J., Zdraveska, M., Tafur, A. J., and Wilkins, H.
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Mortality rate, Cancer, 030204 cardiovascular system & hematology, medicine.disease, Lower risk, Asymptomatic, Optimal management, Pulmonary embolism, Natural history, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, Medicine, In patient, medicine.symptom, business
Abstract: BackgroundCurrent guidelines suggest treating cancer patients with incidental pulmonary embolism (PE) similarly to those with clinically suspected and confirmed PE. However, the natural history of these presentations has not been thoroughly compared.MethodsWe used the data from the RIETE (Registro Informatizado de Enfermedad TromboEmbólica) registry to compare the 3-month outcomes in patients with active cancer and incidental PE versus those with clinically suspected and confirmed PE. The primary outcome was 90-day all-cause mortality. Secondary outcomes were PE-related mortality, symptomatic PE recurrences and major bleeding.ResultsFrom July 2012 to January 2019, 946 cancer patients with incidental asymptomatic PE and 2274 with clinically suspected and confirmed PE were enrolled. Most patients (95% versus 90%) received low-molecular-weight heparin therapy. During the first 90 days, 598 patients died, including 42 from PE. Patients with incidental PE had a lower all-cause mortality rate than those with suspected and confirmed PE (11% versus 22%; OR 0.43, 95% CI 0.34–0.54). Results were consistent for PE-related mortality (0.3% versus 1.7%; OR 0.18, 95% CI 0.06–0.59). Multivariable analysis confirmed that patients with incidental PE were at lower risk of death (adjusted OR 0.43, 95% CI 0.34–0.56). Overall, 29 (0.9%) patients developed symptomatic PE recurrences, and 122 (3.8%) had major bleeding. There were no significant differences in PE recurrences (OR 0.62, 95% CI 0.25–1.54) or major bleeding (OR 0.78, 95% CI 0.51–1.18).ConclusionsCancer patients with incidental PE had a lower mortality rate than those with clinically suspected and confirmed PE. Further studies are required to validate these findings, and to explore optimal management strategies in these patients.
Published: 2020
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14. Prediction of early mortality in patients with cancer-associated thrombosis in the RIETE Database

Author: Fuentes, HE, Tafur, AJ, Caprini, JA, Alatri, A, Trujillo-santos, J, Farge-bancel, D, Rosa, V, Font, L, Vilaseca, A, Monreal, M, Adarraga, MD, Aibar, MA, Aibar, J, Amado, C, Aranda, C, Arcelus, JI, Ballaz, A, Barba, R, Barillari, G, Barron, M, Barron-Andres, B, Bascunana, J, Benzidia, I, Bertoletti, L, Blanco-Molina, A, Bilora, F, Bortoluzzi, C, Bosevski, M, Bounameaux, H, Braester, A, Brandolin, B, Brenner, B, Bucherini, E, Bui, HM, Bura-Riviere, A, Camon, AM, Carrasco, C, Castro, J, Cesta, A, Ciammaichella, M, Cruz, JA, de Ancos, C, del Toro, J, Demelo, P, Dentali, F, Diaz-pedroche, MD, Diaz-Peromingo, JA, Di Micco, P, Di Pangrazio, M, Ellis, M, Encabo, M, Falga, C, Falvo, N, Farfan, AI, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Fresa, M, Furest, I, Garcia, MA, Garcia-Braoado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gil-Diaz, A, Gomez, V, Gomez-Cuervo, C, Gonzalez-Martinez, J, Grandone, E, Grau, E, Guijarro, R, Gutierrez, J, Gutierrez, P, Hernandez-Blasco, L, Hu, A, Hirmerova, J, Imbalzano, E, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jou, I, Joya, MD, Krstevski, G, Lessiani, G, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Nunez, JJ, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Mahe, I, Maida, R, Maly, R, Manrique-Abos, I, Marchena, PJ, Martin-Fernandez, M, Martin-Guerra, JM, Martin-Romero, M, Mastroiacovo, D, Mazzolai, L, Mellado, M, Merah, A, Morales, MD, Moustafa, F, Ney, B, Nieto, JA, Nunez, MJ, Olivares, MD, Otalora, S, Otero, R, Pace, F, Parisi, R, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Perez-Jacoiste, A, Perez-Rus, G, Peris, ML, Pesavento, R, Pesce, ML, Porras, JA, Prandoni, P, Quinta-Valla, R, Riesco, D, Rivas, A, Rocci, A, Rodriguez-Davila, MA, Rodriguez-Hernandez, A, Rubio, CM, Ruiz-Alcaraz, S, Ruiz-Artacho, P, Ruiz-Ruiz, J, Ruiz-Sada, P, Ruiz-Torregrosa, P, Sahuquillo, JC, Sala-Sainz, C, Salgado, E, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Sanoja, ID, Siniscalchi, C, Skride, A, Soler, S, Sotgiu, P, Soto, MJ, Surinach, JM, Tiraferri, E, Tonello, D, Torres, MI, Tufano, A, Tzoran, I, Uresandi, F, Usandizaga, E, Valle, R, Vanassche, T, Vandenbriele, C, Vazquez, FJ, Verhamme, P, Villalobos, A, Visona, A, Hong, NV, Yoo, HH, and Zdraveska, M
Subjects: Neoplasms, Thrombosis, Mortality, premature
Abstract: Background: Proper risk stratification of patients for early mortality after cancer-associated thrombosis may lead to personalized anticoagulation protocols. Therefore, we aimed to derive and validate a scoring system to predict early mortality in this population. To this end, we selected patients with active cancer and thrombosis from the Computerized Registry of Patients with Venous Thromboembolism database. Methods: The main outcome was all cause mortality within the month following a thrombotic event. We used a simple random selection to split arc data in a derivation and a validation cohort. In the derivation cohort, we used recursive partitioning and binary logistic regression to identify groups at risk and to determine the likelihood of the primary outcome. The risk score was developed based on odds ratios from the final multivariate model, and then tested in the validation cohort. Results: In 10,025 eligible patients, we identified 6 predictors of 30-day mortality: leukocytosis >= 11.5x109/L; platelet count = 7). The AUC for the overall score was 0.74, and using a cutoff >= 7 points, the model had a negative predictive value of 94.4%, a positive predictive value of 23.1%, a sensitivity of 73.3%, and a specificity of 64.6% in the validation cohort. Conclusions: Our validated risk model may assist physicians in the selection of patients for outpatient management, and perhaps anticoagulant, considering expanding anticoagulation options.
Published: 2019

15. Frequency and prognostic impact of acute kidney injury in patients with acute pulmonary embolism. Data from the RIETE registry

Author: Murgier, M, Darmon, M, Zeni, F, Valle, R, Del Toro, J, Llamas, P, Mazzolai, L, Villalobos, A, Monreal, M, Brenner, B, Farge-Bancel, D, Barba, R, Di Micco, P, Bertoletti, L, Tzoran, I, Reis, A, Bounameaux, H, Maly, R, Verhamme, P, Bosevski, M, Caprini, JA, Adarraga, MD, Aibar, MA, Aibar, J, Alfonso, M, Amado, C, Aranda, C, Arcelus, JI, Ballaz, A, Barron, M, Barron-Andres, B, Bascunana, J, Blanco-Molina, A, Camon, AM, Carrasco, C, Cruz, AJ, del Pozo, R, del Toro, J, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Encabo, M, Falga, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gomez, V, Gonzalez-Martinez, J, Grau, E, Guijarro, R, Gutierrez, J, Isern, V, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jimenez, J, Jou, I, Joya, MD, Lalueza, A, Lima, J, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Madridano, O, Marchena, PJ, Martin-Martos, F, Martin-Romero, M, Morales, MV, Nieto, JA, Nunez, A, Nunez, MJ, Olivares, MC, Otalora, S, Otero, R, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Peris, ML, Pesce, ML, Porras, JA, Riesco, D, Rivas, A, Rodriguez-Davila, MA, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Soto, MJ, Surinach, JM, Tolosa, C, Torres, MI, Trujillo-Santos, J, Uresandi, F, Usandizaga, E, Vela, J, Vidal, G, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Hirmerova, J, Salgado, E, Benzidia, I, Bura-Riviere, A, Hij, A, Merah, A, Mahe, I, Moustafa, F, Braester, A, EllisM, Bilora, F, Bortoluzzi, C, Brandolin, B, Bucherini, E, Cattabiani, C, Ciammaichella, M, Dentali, F, DiMicco, P, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Maida, R, Mastroiacovo, D, Ngoc, V, Pace, F, Pallotti, G, Parisi, R, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Romualdi, R, Siniscalchi, C, Sotgiu, P, Tiraferri, E, Tonello, D, Tufano, A, Visona, A, Skride, A, Krstevski, G, Zdraveska, M, and Caprini, J
Subjects: Risk, Pulmonary embolism, Bleeding, Mortality, Biomarkers, Acute kidney injury
Abstract: Rationale: Acute kidney injury (AKI) is associated with a poor outcome. Although pulmonary embolism(PE) may promote AKI through renal congestion and/or hemodynamic instability, its frequency and influence on outcome in patients with acute PE have been poorly studied. Methods: The frequency of AKI (defined according to the "Kidney Disease: Improving Global Outcomes" definition) at baseline and its influence on the 30-day mortality was evaluated in patients with acute PE from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry. We used multivariate analysis to assess whether the presence of AKI influenced the risk for 30-day death. Results: The study included 21,131 patients, of whom 6222 (29.5%) had AKI at baseline: 4385 patients (21%) in stage 1, 1385 (6.5%) in stage 2 and 452 (2%) in stage 3. The proportion of patients with high-risk PE in those with no AKI, AKI stage 1, AKI stage 2 or AKI stage 3 was: 2.8%, 5.3%, 8.8% and 12%, respectively (p < 0.001). After 30 days, 1236 patients (5.9%) died. Overall mortality was 4% in patients with no AKI, 8.4% in AKI stage 1, 14% in AKI stage 2 and 17% in AKI stage 3 (all p < 0.001). AKI was independently associated with an increased risk of all-cause death at 30 days (odds ratio = 1.25; 95% CI: 1.02-1.54). Conclusions: One in every 3-4 patients with acute PE had AKI at baseline. The presence of AKI independently predicted 30-day mortality. This study suggests that AKI may deserve to be evaluated as a prognostic factor in patients with acute PE. (C) 2019 Elsevier B.V. All rights reserved.
Published: 2019

16. Venous thromboembolism in young adults: Findings from the RIETE registry

Author: Lacruz, B, Tiberio, G, Latorre, A, Villalba, JC, Bikdeli, B, Hirmerova, J, Lorenzo, A, Mellado, M, Canas, I, Monreal, M, Adarraga, MD, Agud, M, Agudo, P, Aibar, MA, Aibar, J, Amado, C, Arcelus, JI, Ballaz, A, Barba, R, Barron, M, Barron-Andres, B, Bascunana, J, Bolado, C, Blanco-Molina, A, Camon, AM, Carrasco, C, Castro, J, de Ancos, C, del Toro, J, Demelo, P, Diaz-Simon, R, Diaz-Peromingo, JA, Encabo, M, Falga, C, Farfan, AI, Fernandez-Capitan, C, Fernandez-Criado, MC, Fernandez-Ovalle, H, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gaya-Manso, I, Gayol, MC, Gil-Diaz, A, Gomez, V, Gomez-Cuervo, C, Gonzalez-Martinez, J, Grau, E, Gutierrez, J, Hernandez-Blasco, LM, Iglesias, M, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jou, I, Joya, MD, Lalueza, A, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Nunez, JJ, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Loring, M, Madridano, O, Maestre, A, Marchena, PJ, Martin, M, Martin-Fortea, MP, Martin-Guerra, JM, Martinez-Gonzalez, L, Melia, C, Montesa, C, Morales, MV, Nieto, MA, Nieto, JA, Nunez, MJ, Olivares, MC, Otalora, S, Otero, R, Ovejero, A, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Perez-Pinar, M, Perez-Rus, G, Penis, ML, Porras, JA, Redrado, J, Rivas, A, Rodriguez-Galan, I, Rodriguez-Hernandez, A, Rubio, CM, Ruiz-Artacho, P, Ruiz-Ruiz, J, Ruiz-Sada, P, Sahuquillo, JC, Sala-Sainz, MC, Salazar, V, Salgueiro, G, Samperiz, A, Sanchez-Camara, S, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Surinach, JM, Tolosa, C, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Vidal, G, Villares, P, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Verhamme, P, Yoo, HHB, Maly, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Debourdeau, P, Farge-Bancel, D, Hij, A, Mahe, I, Merah, A, Moustafa, F, Schellong, S, Braester, A, Brenner, B, Ellis, M, Tzoran, I, Sharif-Kashani, B, Barillari, G, Bilora, F, Bortoluzzi, C, Brandolin, B, Ciammaichella, M, Dentali, F, Di Micco, P, Grandone, E, Maida, R, Mastroiacovo, D, Pace, F, Parisi, R, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Sotgiu, P, Tufano, A, Visona, A, Hong, NV, Gibietis, V, Kigitovica, D, Skride, A, Bosevski, M, Bounameaux, H, Mazzolai, L, Caprini, J, Bui, HM, and Pham, KQ
Subjects: Young, Anticoagulants, Outcomes, Venous thromboembolism
Abstract: Background: Little is known on the clinical characteristics, risk factors and outcomes during anticoagulation in young patients with acute venous thromboembolism (VTE). Methods: We used data from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the clinical characteristics, risk factors and outcomes during anticoagulation in VTE patients aged 10-24 years. Data were separately analyzed according to initial presentation and gender. Results: Of 76,719 patients with VTE, 1571 (2.0%) were aged 10-24 years. Of these, 989 (63%) were women and 669 (43%) presented with pulmonary embolism (PE). Most women were using estrogens (680, 69%) or were pregnant (101, 10%), while 59% of men had unprovoked VTE. Women were more likely to present with PE (48% vs. 34%). The majority (87%) of PE patients had Sat O-2 levels >= 90% at baseline. The vast majority (97%) of PE patients were at low risk according to the PESI score, many (90%) at very low risk. During the course of anticoagulation (median, 192 days), 40 patients had VTE recurrences, 17 had major bleeding and 10 died (3 died of PE). Women had as many VTE recurrences as major bleeds (15 vs. 14 events), while men had many more VTE recurrences than major bleeding (25 vs. 3 events). Conclusions: VTE is associated with low risk of short-term mortality in young adults. Noticeable gender differences exist in the risk factor profile and the risk of VTE recurrences and major bleeding in the course of anticoagulation.
Published: 2019

17. Will pulmonary embolism diagnosis still be made with ventilation/perfusion imaging?

Author: Bonnefoy, P, Prevot, N, Mehdipoor, G, Sanchez, A, Bikdeli, B, Lima, J, Font, L, Gil-Diaz, A, Llamas, P, Aibar, J, Bertoletti, L, and Monreal, M
Published: 2019

18. Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

Author: Jara-Palomares L, Alfonso M, Maestre A, Jimenez D, Garcia-Bragado F, Font C, Reyes R, Blasco L, Vidal G, Otero R, Monreal M, Adarraga M, Aibar M, Aibar J, Amado C, Arcelus J, Ballaz A, Barba R, Barron M, Barron-Andres B, Bascunana J, Blanco-Molina A, Camon A, Canas I, Carrasco C, Castro J, de Ancos C, Del Toro J, Demelo P, Diaz-Peromingo J, Diaz-Simon R, Falga C, Farfan A, Fernandez-Capitan C, Fernandez-Criado M, Fernandez-Nunez S, Fidalgo A, Font L, Garcia M, Garcia-Morillo M, Garcia-Raso A, Gavin-Sebastian O, Gayol M, Gil-Diaz A, Gomez V, Gomez-Cuervo C, Gonzalez-Martinez J, Grau E, Gutierrez J, Gutierrez-Gonzalez S, Iglesias M, Jaras M, Jou I, Joya M, Lalueza A, Lima J, Llamas P, Lobo J, Lopez-Jimenez L, Lopez-Miguel P, Lopez-Nunez J, Lopez-Saez J, Lorente M, Lorenzo A, Loring M, Madridano O, Marchena P, Martin J, Mellado M, Morales M, Nieto M, Nieto J, Nunez M, Olivares M, Pedrajas J, Pellejero G, Prez-Rus G, Peris M, Porras J, Rivas A, Rodriguez-Davila M, Rodriguez-Hernandez A, Rubio C, Ruiz-Artacho P, Ruiz-Ruiz J, Ruiz-Sada P, Sahuquillo J, Salazar V, Samperiz A, Munoz-Torrero J, Sancho T, Soler S, Surinach J, Tapia E, Tolosa C, Torres M, Trujillo-Santos J, Uresandi F, Valle R, Villares P, Gutierrez P, Vazquez F, Vilaseca A, Vanassche T, Vandenbriele C, Verhamme P, Hirmerova J, Maly R, Celis G, del Pozo G, Salgado E, Benzidia I, Bertoletti L, Bura-Riviere A, Debourdeau P, Farge-Bancel D, Hij A, Mahe I, Moustafa F, Schellong S, Braester A, Brenner B, Tzoran I, Sharif-Kashani B, Barillari G, Bilora F, Bortoluzzi C, Brandolin B, Bucherini E, Ciammaichella M, Dentali F, Di Micco P, Maida R, Mastroiacovo D, Mumoli N, Pace F, Parisi R, Pesavento R, Prandoni P, Quintavalla R, Rocci A, Romualdi R, Sinicalchi C, Tufano A, Visona A, Hong N, Zalunardo B, Gibietis V, Kigitovica D, Skride A, Bosevski M, Bounameaux H, Mazzolai L, Caprini J, Bui H, Pham K, Reis A, and RIETE Investigators
Abstract: In young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged
Published: 2019

19. Mortality after pulmonary embolism in patients with diabetes. Findings from the RIETE registry

Author: de Miguel-Diez, J, Lopez-de-Andres, A, Jimenez-Trujillo, I, Hernandez-Barrera, V, Jimenez-Garcia, R, Lorenzo, A, Pedrajas, JM, Visona, A, Lopez-Miguel, P, Monreal, M, Adarraga, MD, Aibar, MA, Aibar, J, Alfonso, M, Amado, C, Aranda, C, Arcelus, JI, Ballaz, A, Barba, R, Barron, M, Barron-Andres, B, Bascunana, J, Blanco-Molina, A, Camon, AM, Carrasco, C, Cruz, AJ, del Toro, J, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Falga, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Ortega, A, Gavin, O, Gomez, V, Gonzalez-Martinez, J, Grau, E, Guijarro, R, Guirado, L, Gutierrez, J, Hernandez-Blasco, L, Isern, V, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jimenez, J, Jou, I, Joya, MD, Lalueza, A, Lima, J, Lobo, JL, Lopez-Jimenez, L, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Loring, M, Lumbierres, M, Madridano, O, Marchena, PJ, Martin-Martos, Morales, MV, Nieto, JA, Nunez, A, Nunez, MJ, Olivares, MC, Otalora, S, Otero, R, Pellejero, G, Perez-Ductor, C, Perez-Jacoiste, A, Penis, ML, Pesce, ML, Porras, JA, Riesco, D, Rivas, A, Rodriguez-Davila, MA, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Soto, MJ, Surinach, JM, Tolosa, C, Torrents, A, Torres, MI, Trujillo-Santos, J, Uresandi, F, Usandizaga, E, Valle, R, Vela, J, Vidal, G, Villalobos, A, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanasschc, T, Vandenbriele, C, Verhamme, P, Hirmerova, J, Maly, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Farge-Bancel, D, Hij, A, Merah, A, Mahe, I, Moustafa, F, Braester, A, Brenner, B, Ellis, M, Tzoran, I, Bilora, F, Bortoluzzi, C, Brandolin, B, Bucherini, E, Cattabiani, C, Ciammaichella, M, Dentali, F, Di Micco, P, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Maida, R, Mastroiacovo, D, Ngoc, V, Pace, F, Parisi, R, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Sotgiu, P, Tiraferri, E, Tufano, A, Zalunardo, B, Kalejs, R, Skride, A, Vitola, B, Bosevski, M, Zdraveska, M, Ii, B, Fresa, M, Mazzolai, L, Caprini, J, and Bui, HM
Subjects: Cardiovascular events, Type 2 diabetes mellitus, Pulmonary embolism, Comorbidity, Mortality
Abstract: Background: Among patients presenting with pulmonary embolism (PE), those with diabetes are at increased risk to die than those without diabetes. The reasons have not been identified. We used the RIETE (Registro Informatizado Enfermedad Trombo Embolica) database to compare the mortality rate and the causes of death during anticoagulation in patients with PE according to the presence or absence of diabetes. Methods: A matched retrospective cohort study from consecutively enrolled patients in RIETE, from 179 hospitals in 24 countries. For each patient with diabetes we selected two patients with no diabetes matched by age, sex and year of diagnosis of the PE. Results: As of September 2017, there were 2010 PE patients with diabetes and two age-and-gender matched controls. Mean age was 74 +/- 11 years, 46% were men. Patients with diabetes were more likely to have comorbidities, to be using antiplatelets and to have more severe PE. During anticoagulation (median, 219 days), patients with diabetes had a higher mortality (hazard ratio [HR]: 1.45; 95% confidence intervals [CI]: 1.25-1.67) and a higher rate of arterial ischemic events (HR: 2.89; 95%CI: 1.71-4.94) than those without diabetes. On multivariable analysis, diabetes was not associated with an increased risk for death (HR: 1.26; 95%CI: 0.97-1.63). We also failed to find differences according to the use of antiplatelet drugs concomitantly. Conclusions: In our cohort of patients with PE, diabetes was not an independent predictor for death. The influence of arterial events or antiplatelet drugs (if any) was low.
Published: 2019

20. Impact of sex, age, and risk factors for venous thromboembolism on the initial presentation of first isolated symptomatic acute deep vein thrombosis

Author: Barco, S., Klok, F.A., Mahe, I., Marchena, P.J., Ballaz, A., Rubio, C.M., Adarraga, M.D., Mastroiacovo, D., Konstantinides, S.V., Monreal, M., Aibar, M.A., Aibar, J., Akasbi, M., Amado, C., Arcelus, J.I., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Camon, A.M., Carrasco, C., Castro, J., Ancos, C. de, Toro, J. del, Demelo, P., Diaz-Pedroche, M.C., Diaz-Peromingo, J.A., Encabo, M., Falga, C., Farfan, A.I., Fernandez-Aracil, C., Fernandez-Capitan, C., Fernandez-Criado, M.C., Criado, M.C., Fidalgo, M.A., Font, C., Font, L., Garcia, M., Garcia-Bragado, F., Garcia-Morillo, M., Garcia-Raso, A., Garcia-Rodenas, M.M., Gavin, O., Gil-Diaz, A., Gil-Gil, F., Guirado, L., Gomez, V., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez-Blasco, L.M., Iglesias, M., Iglesias-Perez, C., Jara-Palomares, L., Jaras, M.J., Jimenez, D., Jou, I., Joya, M.D., Lima, J., Llamas, P., Lobo, J.L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J.J., Lopez-Reyes, R., Lopez-Saez, J.B., Lorente, M.A., Lorenzo, A., Loring, M., Lumbierres, M., Madridano, O., Maestre, A., Martin-Asenjo, M., Martin-Fernandez, M., Martin-Guerra, J.M., Mellado, M., Morales, M.V., Nieto, J.A., Nunez, M.J., Olivares, M.C., Otalora, S., Otero, R., Pedrajas, J.M., Pellejero, G., Perez-Jacoiste, A., Perez-Rus, G., Peris, M.L., Pesce, M.L., Porras, J.A., Rivas, A., Rodriguez-Davila, M.A., Rodriguez-Hernandez, A., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J.C., Salazar, V., Samperiz, A., Sanchez-Munoz-Torrero, J.F., Sancho, T., Sanoja, I., Soler, S., Soto, M.J., Surinach, J.M., Tolosa, C., Torres, M.I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vidal, G., Gutierrez, P., Vazquez, F.J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Verhamme, P., Hirmerova, J., Maly, R., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Debourdeau, P., Farge-Bancel, D., Hij, A., Moustafa, F., Braester, A., Brenner, B., Ellis, M., Tzoran, I., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Dentali, F., Micco, P. di, Grandone, E., Imbalzano, E., Lessiani, G., Maggi, F., Maida, R., Mumoli, N., Hong, N.V., Pace, F., Parisi, R., Pesavento, R., Prandoni, P., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Kigitovica, D., Skride, A., Sablinskis, K., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Caprini, J., Bui, H.M., RIETE Investigators, Barco, S., Klok, F. A., Mahe, I., Marchena, P. J., Ballaz, A., Rubio, C. M., Adarraga, M. D., Mastroiacovo, D., Konstantinides, S. V., Monreal, M., and Tufano, A.
Subjects: medicine.medical_specialty, Epidemiology, Deep vein, 030204 cardiovascular system & hematology, Distal DVT, 03 medical and health sciences, 0302 clinical medicine, Deep vein thrombosi, Deep vein thrombosis, Internal medicine, medicine, cardiovascular diseases, First episode, Pregnancy, Provoking risk factors, business.industry, Cancer, Hematology, medicine.disease, Thrombosis, Pathophysiology, Pulmonary embolism, medicine.anatomical_structure, Provoking risk factor, 030220 oncology & carcinogenesis, Sex, business, Venous thromboembolism
Abstract: Background and aims Sex-specific differences exist for the initial presentation of acute venous thromboembolism (VTE): men are more likely to present with proximal deep vein thrombosis (DVT) in the lower limbs (versus pulmonary embolism [PE] or isolated distal DVT [IDDVT]) than women. We studied in detail the influence of sex, age, and VTE risk factors on the initial presentation of IDDVT versus proximal DVT. Methods A total of 24,911 patients with a first episode of objectively diagnosed acute symptomatic lower-limb DVT (without symptomatic PE) were enrolled in RIETE (years 2000–2017) and included in the present analysis. Results A total of 4266 (17.1%) patients had IDDVT. No trend for more IDDVT diagnoses was observed over time. Women aged 40–69 had a higher proportion of IDDVT, especially between 40 and 49 years (+6.7%; 95CI +3.7%; +9.9%), whereas men had more often proximal DVT. The presenting location of first acute DVT depended on sex, age, and the prevalence and type of VTE risk factors. Recent surgery was independently associated with a diagnosis of IDDVT in both women and men, whereas active cancer and pregnancy were associated with proximal DVT. Conclusions The interaction between age and VTE risk factors influences the presenting location (distal versus proximal) of the first acute lower-limb DVT observed in women and men. Our observations extend to IDDVT the concept that different clinical manifestations of acute VTE may not fully share the same pathophysiological mechanisms: this contributes to explain sex-specific prognostic differences.
Published: 2019

21. Weed harrowing in winter cereal under semi-arid conditions

Author: Pardo, G., Cirujeda, A., Aibar, J., Cavero, J., and Zaragoza, C.
Subjects: Weeds and weed control, HORDEUM VULGARE, TRITICUM DURUM, WEEDS, WEEDING, WEED CONTROL EQUIPMENT, POSTEMERGENCE APPLICATION, WEED CONTROL, SEMIARID ZONES, MALEZAS, ESCARDA MECANICA, EQUIPO PARA EL CONTROL DE MALEZAS, APLICACION EN POSTEMERGENCIA, ESCARDA, ZONA SEMIARIDA
Abstract: Five field experiments on barley and wheat have been carried out in North-Eastern Spain on the same field during the cropping seasons 1999-00 to 2003-04 to compare the effect of different harrowing adjustments on weed control, weed biomass and cereal yield. The variables considered were harrowing timing (pre- or early post-emergence), one or two passes, travelling direction, harrowing depth and speed compared with an untreated control and herbicide. Excepting year 2001, with very little weed emergence, mechanical control as a whole caused a significant weed plant reduction compared to the untreated plots in all years. No influence of harrowing depth and travelling speed and of pre-emergence harrowing were found in the trials. A single harrowing treatment conducted across the sowing direction gave the same or less control compared to harrowing along the sowing direction. Two harrowing passes achieved a higher efficacy than one single pass and little differences were detected if the second pass was conducted the same day, across the sowing direction or 15 days later. Despite herbicide had generally a higher efficacy than the harrowing treatments, in three out of five years it was found a mechanical control with the same control than herbicide. The effect of the different treatments on weed biomass was lower than on weed number and no significant differences were found for grain yield. Considering that an herbicide treatment in the present conditions is three times more expensive than harrowing, a single post-emergence harrowing can be considered a valid option for low and medium-infested cereal fields., En este trabajo se muestran los resultados de cinco experimentos de campo localizados en el noreste de España desde 1999-00 hasta 2003-04. En ellos se comparó el efecto de distintas formas de control mecánico de la flora arvense con grada de varillas flexibles sobre la densidad y biomasa de la misma y sobre la producción de cereal comparado con un control sin tratar y el uso de herbicidas. Las variables consideradas fueron: momento y número de pases de grada, profundidad, dirección y velocidad de los pases. Excepto en 2001, con una baja infestación, el control mecánico redujo la densidad de arvenses en comparación con las parcelas sin tratar. La profundidad y la velocidad de la labor no tuvieron influencia clara y realizar el pase en preemergencia del cereal resultó ineficaz probablemente debido a la falta de humedad. Dos pases resultaron más eficaces que uno y se encontraron pocas diferencias si el segundo se hacía en el mismo día, perpendicular o 15 días después. Aunque el herbicida tuvo generalmente mayor eficacia que los tratamientos mecánicos, en tres años se encontró un tratamiento mecánico con eficacia similar. El efecto de los distintos tratamientos sobre la biomasa de arvenses fue menor que sobre el número de las mismas y no hubo diferencias significativas sobre la producción. Dado que el tratamiento herbicida en las condiciones del ensayo fue tres veces más caro que el tratamiento mecánico, un único pase en post-emergencia puede ser una opción válida con infestaciones medias o bajas de malas hierbas.
Published: 2008

22. Producción y gestión del compost

Author: Negro, M. J., Villa, F., Aibar, J., Aracón, R., Ciria, P., Cristóbal, M. V., Benito, A. de, García Martín, A., Garcia Muriedas, G., Labrador, C., Lacasta Dutoit, Carlos, Lezaún, J. A., Meco, R., Pardo, Gabriel, Solano, M. L., Torner, C., and Zaragoza, C.
Subjects: Compostaje, Estiércol
Abstract: 31 páginas, tablas estadísticas, figuras, El compostaje es un proceso biológico aerobio, que bajo condiciones de aireación, humedad y temperaturas controladas y combinando fases mesófilas (temperatura y humedad medias) y termófilas (temperatura superior a 45ºC), transforma los residuos orgánicos degradables, en un producto estable e higienizado, aplicable como abono o sustrato. Es decir, el compostaje es: - una técnica de estabilización y tratamiento de residuos orgánicos biodegradables. El calor generado durante el proceso (fase termófila) va a destruir las bacterias patógenas, huevos de parásitos y muchas semillas de malas hierbas que pueden encontrarse en el material de partida, dando lugar a un producto higienizado. - una técnica biológica de reciclaje de materia orgánica que al final de su evolución da humus, factor de estabilidad y fertilidad del suelo. - el resultado de una actividad biológica compleja, realizado en condiciones particulares; el compostaje no es, por tanto, un único proceso. Es, en realidad, la suma de una serie de procesos metabólicos complejos procedentes de la actividad integrada de un conjunto de microorganismos. Los cambios químicos y especies involucradas en el mismo varían de acuerdo a la composición del material que se quiere compostar. El producto obtenido al final de un proceso de compostaje, el compost, posee un importante contenido en materia orgánica y nutrientes, pudiendo ser aprovechado como abono orgánico o como substrato.
Published: 2000

23. Economic evaluation of cereal cropping systems under semiarid conditions: Minimum input, organic and conventional | Avaliação econômica de sistemas de cultivo de cereias em condições semiáridas: Cultivo mínimo, orgânico e convencional

Author: Gabriel Pardo Sanclemente, Aibar, J., Cavero, J., and Zaragoza, C.
Subjects: rotação de culturas, crop rotation, lucratividade, organic agriculture, profitability, agricultura orgânica, lcsh:Agriculture (General), lcsh:S1-972
Abstract: Cropping systems like organic farming, selling products at a higher price and promoting environmental sustainability by reducing fertilizer and pesticides, can be more profitable than conventional systems. An economic evaluation of three cropping systems in a seven year period experiment was performed, using a common rotation (fallow-barley-vetch-durum wheat) in a semi-arid rainfed field of Spain. The minimum input system included mouldboard ploughing, cultivator preparation, sowing and harvest. The conventional system involved mineral fertilizer and herbicide treatments, while the organic system involved composted manure and mechanical weed control. The resulting economic margins were highest with the minimum input system, followed by the organic and conventional systems. If the cereal grain from the minimum input system was sold at a higher price on the organic market, this system was the most profitable. Without the price difference, the organic system was as profitable as the conventional one.Sistemas de cultivo como agricultura orgânica, cujos produtos têm custo mais alto, mas que promova sustentabilidade ambiental pela redução do uso de fertilizantes e pesticidas, pode ser mais lucrativo do que sistemas convencionais de cultivo. Efetuou-se uma avaliação econômica de três sistemas de cultivo num período experimental de sete anos, utilizando um sistema comum de rotação (pousio-cevada-ervilhaca-trigo duro), sem irrigação, em um local semi-árido da Espanha. O sistema de cultivo mínimo incluía aração com aiveca, preparo com cultivador, semeadura e colheita. O sistema convencional envolvia tratamentos com herbicidas e fertilizantes minerais, enquanto o sistema orgânico envolvia adubação com composto e controle mecânico de ervas invasoras. O sistema com maior retorno econômico foi o de cultivo mínimo, seguido do orgânico e do convencional. O sistema de cultivo mínimo foi o mais lucrativo quando o cereal foi vendido num preço mais alto no mercado orgânico. Sem essa diferença de preços os sistemas apresentaram lucratividades semelhantes.

24. Heart Rate and Mortality in Patients With Acute Symptomatic Pulmonary Embolism

Author: G. Pellejero, Jose Gutierrez, R. Malý, M. Basaglia, L. Chasco, P. Suchon, R. Le Mao, Laurent Bertoletti, F. Martins, J. Caprini, A. Braester, F. Galeano-Valle, Hanh My Bui, J. Alonso, Y. Sato, G. Vidal, Y. Nishimoto, C. Tolosa, E. Nofuentes-Pérez, A.M. Díaz-Brasero, N. Ait Abdallah, M.D. Adarraga, R. Sánchez-Martínez, L. Font, Raquel López-Reyes, Inna Tzoran, Karine Lacut, J. del Toro, Andris Skride, Ana Jaureguizar, Joseph A. Caprini, C. Amado, R. García de la Garza, A.M. Camon, S. Merla, Luciano López-Jiménez, G. Salgueiro, Sebastian Schellong, Alfonso Muriel, F. Bilora, S. Lainez-Justo, B. Suárez-Rodríguez, Carme Font, F. Beddar Chaib, I. Francisco, C. Jiménez-Alfaro, P. Azcarate-Agüero, Maurizio Ciammaichella, J.A. Porras, N. Vo Hong, F. Martín-Martos, Dominique Farge-Bancel, D. Farge-Bancel, José Luis Lobo, M. Giménez-Suau, E. Grau, F. García-Bragado, Ángeles Blanco-Molina, Carmen Fernández-Capitán, María del Carmen Díaz-Pedroche, C. Grange, Adriana Visonà, L. Guirado, P. Villares, P. López-Miguel, José María Pedrajas, S. Accassat, Beatriz Valero, B. Crichi, Juan J. López-Núñez, Luis Jara-Palomares, G. Sarlon-Bartoli, J. Lima, C. Bortoluzzi, Alicia Lorenzo, C. de Ancos, M.A. Fidalgo, Philippe Debourdeau, Pablo Javier Marchena, C. Rodríguez-Matute, A.I. Farfán-Sedano, José Luis Fernández-Reyes, J.C. Escribano, Juan I. Arcelus, M. Barrón, I. Quere, Remedios Otero, A. De Angelis, P. Morange, Peter Verhamme, G. Kenet, P. Prandoni, Pedro Ruiz-Artacho, C. Siniscalchi, A. Zaicenko, M. Olid-Velilla, C. García-Díaz, B. Barrón-Andrés, T. Sancho, Fernando Uresandi, Javier Trujillo-Santos, A. Muñoz-Blanco, A. Villalobos, A. Dubois-Silva, J. Moisés, J. Osorio, M.I. Mercado, J.M. Suriñach, M.A. Aibar, M.D. Joya, Cihan Ay, J.A. Díaz-Peromingo, H. Bounameaux, Diego Martínez-Urbistondo, Thomas Vanassche, L. Bertoletti, Marijan Bosevski, Farès Moustafa, M. Martín del Pozo, J.F. Sánchez-Muñoz-Torrero, H.M. Bui, Ingrid Pabinger, M.C. Olivares, M. García de Herreros, M.J. Núñez-Fernández, B. Zalunardo, J.F. Varona, Stephan Nopp, Behnood Bikdeli, B. Brandolin, B. Bikdeli, Olga Madridano, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, Abílio Reis, J. Portillo, O. Espitia, J. Catella, Aitor Ballaz, F. Esposito, R. Barba, R. Valle, H. Helfer, I. Tzoran, J.B. López-Sáez, P. Ruiz-Artacho, M.A. García, J. Aibar, C. Gómez-Cuervo, C. Gabara, A. Latorre, J. Ruiz-Ruiz, Benjamin Brenner, S. Fonseca, S. Schellong, Raffaele Pesavento, Barry M. Brenner, Silvia Soler, Paolo Prandoni, Victor F. Tapson, Ana Maestre, Pierpaolo Di Micco, M. Muñoz, J. Criado, D. Jiménez, Antonella Tufano, G. Krstevski, B. Valero, Henri Bounameaux, M.I. Torres, G. Poenou, Isabelle Mahé, Aída Gil-Díaz, A. Asuero, S. Otalora, V. Rosa, L. Vela, E. Imbalzano, C. Vandenbriele, C. Barbagelata, Jana Hirmerova, J. Meireles, David Jiménez, Lucia Mazzolai, L. Hernández-Blasco, M. Bosevski, Gili Kenet, C. Mella, M. Monreal, J.R. Vela, P. Di Micco, Carlos Zamora, K. Flores, P. Demelo-Rodríguez, Radovan Malý, J. Birzulis, J.A. Nieto, J. Castro, M.V. Di Campli, Francis Couturaud, Raquel Barba, Jaureguizar, A., Jimenez, D., Bikdeli, B., Ruiz-Artacho, P., Muriel, A., Tapson, V., Lopez-Reyes, R., Valero, B., Kenet, G., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Verhamme, P., Caprini, J. A., Bui, H. M., Adarraga, M. D., Aibar, J., Aibar, M. A., Alonso, J., Amado, C., Arcelus, J. I., Asuero, A., Azcarate-Aguero, P., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Beddar Chaib, F., Camon, A. M., Castro, J., Chasco, L., Criado, J., de Ancos, C., del Toro, J., Demelo-Rodriguez, P., Diaz-Brasero, A. M., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Di Campli, M. V., Dubois-Silva, A., Escribano, J. C., Esposito, F., Farfan-Sedano, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia de Herreros, M., Garcia de la Garza, R., Garcia-Diaz, C., Gil-Diaz, A., Gomez-Cuervo, C., Gimenez-Suau, M., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez-Alfaro, C., Joya, M. D., Lainez-Justo, S., Latorre, A., Lima, J., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Saez, J. B., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Urbistondo, D., Mella, C., Mercado, M. I., Moises, J., Munoz, M., Munoz-Blanco, A., Nieto, J. A., Nofuentes-Perez, E., Nunez-Fernandez, M. J., Olid-Velilla, M., Olivares, M. C., Osorio, J., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Porras, J. A., Portillo, J., Rodriguez-Matute, C., Rosa, V., Ruiz-Ruiz, J., Salgueiro, G., Sanchez-Martinez, R., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Suarez-Rodriguez, B., Surinach, J. M., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J. F., Vela, L., Vela, J. R., Vidal, G., Villalobos, A., Villares, P., Zamora, C., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Vandenbriele, C., Hirmerova, J., Accassat, S., Ait Abdallah, N., Bura-Riviere, A., Catella, J., Couturaud, F., Crichi, B., Debourdeau, P., Espitia, O., Grange, C., Helfer, H., Lacut, K., Le Mao, R., Mahe, I., Morange, P., Moustafa, F., Poenou, G., Sarlon-Bartoli, G., Suchon, P., Quere, I., Braester, A., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., De Angelis, A., Imbalzano, E., Merla, S., Pesavento, R., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Nishimoto, Y., Sato, Y., Birzulis, J., Skride, A., Zaicenko, A., Fonseca, S., Martins, F., Meireles, J., Krstevski, G., and Mazzolai, L.
Subjects: Male, Registrie, Pulmonary and Respiratory Medicine, medicine.medical_specialty, pulmonary embolism, Critical Care and Intensive Care Medicine, Logistic regression, Heart Rate, Internal medicine, Heart rate, medicine, In patient, Aged, Aged, 80 and over, business.industry, medicine.disease, mortality, Pulmonary embolism, Prospective Studie, Increased risk, Spain, Cardiology, Positive relationship, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract: Background: The association between heart rate (HR) and pulmonary embolism (PE) outcomes has not been well studied. Furthermore, optimal cutoffs to identify low-risk and intermediate- to high-risk patients are not well known. Research Question: Does an association exist between baseline HR and PE outcome across the continuum of HR values? Study Design and Methods: The current study included 44,331 consecutive nonhypotensive patients with symptomatic PE from the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2021. Outcomes included 30-day all-cause and PE-specific mortality. We used hierarchical logistic regression to assess the association between admission HR and outcomes. Results: A positive relationship was found between admission HR and 30-day all-cause and PE-related mortality. Considering an HR of 80 to 99 beats/min as a reference, patients in the higher HR strata showed higher rates of all-cause death (adjusted OR, 1.5 for HR of 100-109 beats/min; adjusted OR, 1.7 for HR of 110-119 beats/min; adjusted OR, 1.9 for HR of 120-139 beats/min; and adjusted OR, 2.4 for HR of ≥ 140 beats/min). Patients in the lower strata of HR showed significantly lower rates of 30-day all-cause mortality compared with the same reference group (adjusted OR, 0.6 for HR of 60-79 beats/min; and adjusted OR, 0.5 for HR of < 60 beats/min). The findings for 30-day PE-related mortality were similar. For identification of low-risk patients, a cutoff value of 80 beats/min (vs 110 beats/min) increased the sensitivity of the simplified Pulmonary Embolism Severity Index (sPESI) from 93.4% to 98.8%. For identification of intermediate- to high-risk patients, a cutoff value of 140 beats/min (vs 110 beats/min) increased the specificity of the Bova score from 93.2% to 98.0%. Interpretation: In nonhypotensive patients with acute symptomatic PE, a high HR portends an increased risk of all-cause and PE-related mortality. Modifying the HR cutoff in the sPESI and the Bova score improves prognostication of patients with PE.
Published: 2022
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25. Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study

Author: Trujillo-Santos J, Farge-Bancel D, Pedrajas JM, Gómez-Cuervo C, Ballaz A, Braester A, Mahé I, Villalobos A, Porras JA, Monreal M, RIETE Investigators, M D Adarraga, J Aibar, M A Aibar, C Amado, J I Arcelus, A Asuero, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, A Blanco-Molina, E Botella, A M Camon, I Casado, J Castro, M Castro, L Chasco, J Criado, C de Ancos, J Del Toro, P Demelo-Rodríguez, A M Díaz-Brasero, J A Díaz-Peromingo, M V Di Campli, A Dubois-Silva, J C Escribano, F Espósito, C Falgá, A I Farfán-Sedano, C Fernández-Capitán, J L Fernández-Reyes, M A Fidalgo, K Flores, C Font, L Font, I Francisco, C Gabara, F Galeano-Valle, M A García, F García-Bragado, M García de Herreros, R García de la Garza, C García-Díaz, R García-Hernáez, A García-Raso, A Gil-Díaz, M Giménez-Suau, E Grau, L Guirado, J Gutiérrez, L Hernández-Blasco, E Hernando, L Jara-Palomares, M J Jaras, D Jiménez, R Jiménez, C Jiménez-Alfaro, M D Joya, S Lainez-Justo, A Latorre, J Lima, P Llamas, J L Lobo, L López-Jiménez, P López-Miguel, J J López-Núñez, R López-Reyes, J B López-Sáez, A Lorenzo, O Madridano, A Maestre, P J Marchena, F Martín-Martos, D Martínez-Urbistondo, C Mella, M I Mercado, J Moisés, M V Morales, A Muñoz-Blanco, N Muñoz-Rivas, M S Navas, J A Nieto, E Nofuentes-Pérez, M J Núñez-Fernández, B Obispo, M Olid, M C Olivares, J L Orcastegui, J Osorio, S Otalora, R Otero, D Paredes, P Parra, G Pellejero, J Portillo, F Rivera-Civico, D A Rodríguez-Chiaradía, C Rodríguez-Matute, J Rogado, V Rosa, P Ruiz-Artacho, N Ruiz-Giménez, J Ruiz-Ruiz, P Ruiz-Sada, G Salgueiro, R Sánchez-Martínez, J F Sánchez-Muñoz-Torrero, T Sancho, S Soler, B Suárez-Rodríguez, J M Suriñach, R Tirado, M I Torres, C Tolosa, F Uresandi, B Valero, R Valle, J F Varona, G Vidal, P Villares, C Zamora, M Engelen, T Vanassche, P Verhamme, J Hirmerova, R Malý, N Ait Abdallah, L Bertoletti, A Bura-Riviere, J Catella, F Couturaud, B Crichi, P Debourdeau, O Espitia, N Falvo, H Helfer, K Lacut, R Le Mao, F Moustafa, G Poenou, I Quere, S Schellong, B Brenner, I Tzoran, R Nikandish, F Bilora, B Brandolin, M Ciammaichella, P Di Micco, E Imbalzano, R Maida, F Pace, R Pesavento, P Prandoni, R Quintavalla, A Rocci, C Siniscalchi, A Tufano, A Visonà, B Zalunardo, J Birzulis, A Skride, A Zaicenko, S Fonseca, F Martins, J Meireles, M Bosevski, H Bounameaux, L Mazzolai, C I Ochoa-Chaar, I Weinberg, H M Bui, J, Trujillo-Santo, D, Farge-Bancel, Jm, Pedraja, C, Gómez-Cuervo, A, Ballaz, A, Braester, I, Mahé, A, Villalobo, Ja, Porra, M, Monreal, Investigators, Riete, D Adarraga, M, Aibar, J, A Aibar, M, Amado, C, I Arcelus, J, Asuero, A, Barba, R, Barbagelata, C, Barrón, M, Barrón-Andrés, B, Blanco-Molina, A, Botella, E, M Camon, A, Casado, I, Castro, J, Castro, M, Chasco, L, Criado, J, de Ancos, C, Del Toro, J, Demelo-Rodríguez, P, M Díaz-Brasero, A, A Díaz-Peromingo, J, V Di Campli, M, Dubois-Silva, A, C Escribano, J, Espósito, F, Falgá, C, I Farfán-Sedano, A, Fernández-Capitán, C, L Fernández-Reyes, J, A Fidalgo, M, Flores, K, Font, C, Font, L, Francisco, I, Gabara, C, Galeano-Valle, F, A García, M, García-Bragado, F, García de Herreros, M, García de la Garza, R, García-Díaz, C, García-Hernáez, R, García-Raso, A, Gil-Díaz, A, Giménez-Suau, M, Grau, E, Guirado, L, Gutiérrez, J, Hernández-Blasco, L, Hernando, E, Jara-Palomares, L, J Jaras, M, Jiménez, D, Jiménez, R, Jiménez-Alfaro, C, D Joya, M, Lainez-Justo, S, Latorre, A, Lima, J, Llamas, P, L Lobo, J, López-Jiménez, L, López-Miguel, P, J López-Núñez, J, López-Reyes, R, B López-Sáez, J, Lorenzo, A, Madridano, O, Maestre, A, J Marchena, P, Martín-Martos, F, Martínez-Urbistondo, D, Mella, C, I Mercado, M, Moisés, J, V Morales, M, Muñoz-Blanco, A, Muñoz-Rivas, N, S Navas, M, A Nieto, J, Nofuentes-Pérez, E, J Núñez-Fernández, M, Obispo, B, Olid, M, C Olivares, M, L Orcastegui, J, Osorio, J, Otalora, S, Otero, R, Paredes, D, Parra, P, Pellejero, G, Portillo, J, Rivera-Civico, F, A Rodríguez-Chiaradía, D, Rodríguez-Matute, C, Rogado, J, Rosa, V, Ruiz-Artacho, P, Ruiz-Giménez, N, Ruiz-Ruiz, J, Ruiz-Sada, P, Salgueiro, G, Sánchez-Martínez, R, F Sánchez-Muñoz-Torrero, J, Sancho, T, Soler, S, Suárez-Rodríguez, B, M Suriñach, J, Tirado, R, I Torres, M, Tolosa, C, Uresandi, F, Valero, B, Valle, R, F Varona, J, Vidal, G, Villares, P, Zamora, C, Engelen, M, Vanassche, T, Verhamme, P, Hirmerova, J, Malý, R, Ait Abdallah, N, Bertoletti, L, Bura-Riviere, A, Catella, J, Couturaud, F, Crichi, B, Debourdeau, P, Espitia, O, Falvo, N, Helfer, H, Lacut, K, Le Mao, R, Moustafa, F, Poenou, G, Quere, I, Schellong, S, Brenner, B, Tzoran, I, Nikandish, R, Bilora, F, Brandolin, B, Ciammaichella, M, Di Micco, P, Imbalzano, E, Maida, R, Pace, F, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tufano, A, Visonà, A, Zalunardo, B, Birzulis, J, Skride, A, Zaicenko, A, Fonseca, S, Martins, F, Meireles, J, Bosevski, M, Bounameaux, H, Mazzolai, L, I Ochoa-Chaar, C, Weinberg, I, and M Bui, H
Subjects: dalteparin, recurrences, tinzaparin, venous thromboembolism, cancer, enoxaparin, Hematology, cohort, LMWH
Abstract: Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a leading cause of morbidity and death. The objective of the RIETECAT study was to compare the long-term effectiveness and safety of enoxaparin versus dalteparin or tinzaparin for the secondary prevention of VTE in adults with active cancer. We used the data from the multicenter, multinational RIETE registry to compare the rates of VTE recurrences, major bleeding, or death over 6 months in patients with active cancer and acute VTE using full doses of enoxaparin versus dalteparin or tinzaparin, and a multivariable Cox proportional hazard model was used to analyze the primary end point. From January 2009 to June 2018, 4451 patients with active cancer received full doses of the study drugs: enoxaparin, 3526 patients; and dalteparin or tinzaparin, 925 (754 + 171) patients. There was limited difference in VTE recurrences (2.0% vs 2.5%) and mortality rate (19% vs 17%) between the enoxaparin and dalteparin or tinzaparin subgroups. However, there was a slight numerical increase in major bleeding (3.1% vs 1.9%). Propensity score matching confirmed that there were no differences in the risk for VTE recurrences (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.48-1.38), major bleeding (aHR, 1.40; 95% CI, 0.80-2.46), or death (aHR, 1.07; 95% CI, 0.88-1.30) between subgroups. In RIETECAT, in patients with cancer and VTE receiving full-dose enoxaparin or dalteparin or tinzaparin, no statistically significant differences were observed regarding effectiveness and safety outcomes over a 6-month period.
Published: 2022

26. Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study

Author: Marc Blondon, David Jimenez, Helia Robert‐Ebadi, Jorge Del Toro, Luciano Lopez‐Jimenez, Conxita Falga, Andris Skride, Llorenç Font, Fernando Javier Vazquez, Henri Bounameaux, Manuel Monreal, Paolo Prandoni, Benjamin Brenner, Dominique Farge‐Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Radovan Malý, Peter Verhamme, Joseph A Caprini, Hanh My Bui, MD Adarraga, M Agud, J Aibar, MA Aibar, J Alfonso, C Amado, JI Arcelus, C Baeza, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón‐Andrés, A Blanco‐Molina, E Botella, AM Camon, J Castro, MA Caudevilla, P Cerdà, L Chasco, J Criado, C de Ancos, J de Miguel, P Demelo‐Rodríguez, JA Díaz‐Peromingo, J Díez‐Sierra, R Díaz‐Simón, IM Domínguez, M Encabo, JC Escribano, C Falgá, AI Farfán, C Fernández‐Capitán, JL Fernández‐Reyes, MA Fidalgo, K Flores, C Font, I Francisco, C Gabara, F Galeano‐Valle, MA García, F García‐Bragado, MM García‐Mullor, O Gavín‐Blanco, O Gavín‐Sebastián, A Gil‐Díaz, C Gómez‐Cuervo, J González‐Martínez, E Grau, L Guirado, J Gutiérrez, L Hernández‐Blasco, L Jara‐Palomares, MJ Jaras, D Jiménez, MD Joya, I Jou, B Lacruz, R Lecumberri, J Lima, JL Lobo, H López‐Brull, L López‐Jiménez, P López‐Miguel, JJ López‐Núñez, R López‐Reyes, JB López‐Sáez, MA Lorente, A Lorenzo, M Loring, O Madridano, A Maestre, PJ Marchena, M Martín del Pozo, F Martín‐Martos, C Martínez‐Baquerizo, C Mella, M Mellado, MI Mercado, J Moisés, MV Morales, A Muñoz‐Blanco, D Muñoz‐Guglielmetti, N Muñoz‐Rivas, E Nart, JA Nieto, MJ Núñez, MC Olivares, C Ortega‐Michel, MD Ortega‐Recio, J Osorio, S Otalora, R Otero, P Parra, V Parra, JM Pedrajas, G Pellejero, A Pérez‐Jacoiste, ML Peris, D Pesántez, JA Porras, J Portillo, L Reig, A Riera‐Mestre, A Rivas, A Rodríguez‐Cobo, C Rodríguez‐Matute, J Rogado, V Rosa, CM Rubio, P Ruiz‐Artacho, N Ruiz‐Giménez, J Ruiz‐Ruiz, P Ruiz‐Sada, JC Sahuquillo, G Salgueiro, A Sampériz, JF Sánchez‐Muñoz‐Torrero, T Sancho, P Sigüenza, M Sirisi, S Soler, S Suárez, JM Suriñach, G Tiberio, MI Torres, C Tolosa, J Trujillo‐Santos, F Uresandi, E Usandizaga, R Valle, JR Vela, G Vidal, C Vilar, P Villares, C Zamora, P Gutiérrez, FJ Vázquez, T Vanassche, C Vandenbriele, P Verhamme, J Hirmerova, R Malý, E Salgado, I Benzidia, L Bertoletti, A Bura‐Riviere, B Crichi, P Debourdeau, O Espitia, D Farge‐Bancel, H Helfer, I Mahé, F Moustafa, G Poenou, S Schellong, A Braester, B Brenner, I Tzoran, M Amitrano, F Bilora, C Bortoluzzi, B Brandolin, M Ciammaichella, D Colaizzo, F Dentali, P Di Micco, E Giammarino, E Grandone, S Mangiacapra, D Mastroiacovo, R Maida, N Mumoli, F Pace, R Pesavento, F Pomero, P Prandoni, R Quintavalla, A Rocci, C Siniscalchi, A Tufano, A Visonà, N Vo Hong, B Zalunardo, RV Kalejs, K Maķe, M Ferreira, S Fonseca, F Martins, J Meireles, M Bosevski, M Zdraveska, L Mazzolai, JA Caprini, AJ Tafur, I Weinberg, H Wilkins, HM Bui, Blondon, M., Jimenez, D., Robert-Ebadi, H., Del Toro, J., Lopez-Jimenez, L., Falga, C., Skride, A., Font, L., Vazquez, F. J., Bounameaux, H., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Maly, R., Verhamme, P., Caprini, J. A., My Bui, H., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Arcelus, J. I., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Botella, E., Camon, A. M., Castro, J., Caudevilla, M. A., Cerda, P., Chasco, L., Criado, J., de Ancos, C., de Miguel, J., Demelo-Rodriguez, P., Diaz-Peromingo, J. A., Diez-Sierra, J., Diaz-Simon, R., Dominguez, I. M., Encabo, M., Escribano, J. C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Mullor, M. M., Gavin-Blanco, O., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Joya, M. D., Jou, I., Lacruz, B., Lecumberri, R., Lima, J., Lobo, J. L., Lopez-Brull, H., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Baquerizo, C., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Munoz-Rivas, N., Nart, E., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Michel, C., Ortega-Recio, M. D., Osorio, J., Otalora, S., Otero, R., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Perez-Jacoiste, A., Peris, M. L., Pesantez, D., Porras, J. A., Portillo, J., Reig, L., Riera-Mestre, A., Rivas, A., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rogado, J., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Siguenza, P., Sirisi, M., Soler, S., Suarez, S., Surinach, J. M., Tiberio, G., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vidal, G., Vilar, C., Villares, P., Zamora, C., Gutierrez, P., Vanassche, T., Vandenbriele, C., Hirmerova, J., Salgado, E., Benzidia, I., Bura-Riviere, A., Crichi, B., Debourdeau, P., Espitia, O., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Braester, A., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., Colaizzo, D., Dentali, F., Giammarino, E., Grandone, E., Mangiacapra, S., Mastroiacovo, D., Maida, R., Mumoli, N., Pace, F., Pesavento, R., Pomero, F., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Kalejs, R. V., Maie, K., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Zdraveska, M., Mazzolai, L., Tafur, A. J., Weinberg, I., Wilkins, H., and Bui, H. M.
Subjects: Registrie, medicine.medical_specialty, pulmonary embolism, Prognosi, Hemodynamics, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, Clinical prognosis, 0302 clinical medicine, Recurrence, Internal medicine, Case fatality rate, medicine, Humans, hemorrhage, mortality, prognosis, thrombolytic therapy, Registries, cardiovascular diseases, business.industry, Anticoagulant, Anticoagulants, Hematology, Venous Thromboembolism, Prognosis, medicine.disease, Confidence interval, Pulmonary embolism, Discontinuation, Cohort Studie, business, Venous thromboembolism, Cohort study, Human
Abstract: Aims Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. Methods and results We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (
Published: 2021

27. Incidence of major adverse cardiovascular events among patients with provoked and unprovoked venous thromboembolism: Findings from the Registro Informatizado de Enfermedad Tromboembólica Registry

Author: Fernando J. Vazquez, Hanh My Bui, R. Maida, Alicia Lorenzo, Iva Golemi, Remedios Otero, R. Otero, G. Pellejero, Pilar Llamas, M.J. Soto, J. del Toro, Inna Tzoran, K. Sablinskis, Carmine Siniscalchi, E. Bucherini, G. Vidal, Juan J. López-Núñez, N. Mumoli, J.M. Suriñach, S. Ruiz-Alcaraz, H. Bounameaux, Jose Gutierrez, E. Salgado, C. Carrasco, I. Gaya, R. Parisi, M.D. Adarraga, Peter Verhamme, Meritxell Mellado, N. Vo Hong, I. Jou, M.C. Gayol, M. García-Morillo, Marco Fresa, Luis Jara-Palomares, Daniela Mastroiacovo, M. Sablinskis, A. Rodríguez-Hernández, R. Díaz-Simón, Miguel Ángel Aibar, David Jiménez, Ángel Sampériz, Raquel López-Reyes, Isabelle Mahé, P. Ruiz-Sada, Martin Ellis, J.A. Porras, Omer Iftikhar, Ángeles Blanco-Molina, J. Aibar, R. Malý, M. Pérez-Pinar, Adriana Visonà, L. Guirado, Carme Font, M. Encabo, M.A. Lorente, María del Carmen Díaz-Pedroche, F. García-Bragado, Gianfranco Lessiani, P. Prandoni, T. Sancho, I. Sanoja, A. Tafur, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, Javier Trujillo-Santos, E. Grau, J. Castro, E. Imbalzano, P. Demelo, A.M. Camon, P. López-Miguel, R. Quintavalla, Alfonso Tafur, Laurent Bertoletti, N. Falvo, J. Ruiz-Ruiz, M. Pinelli, M.A. Fidalgo, Pablo Javier Marchena, Anna Rocci, Aitor Ballaz, José González-Martínez, Andrei Braester, J.F. Sánchez-Muñoz-Torrero, J. Bascuñana, Philippe Debourdeau, J.M. Pedrajas, Giovanni Barillari, C. Vandenbriele, H.M. Bui, M. Iglesias, M. Bosevski, Raffaele Pesavento, Barry M. Brenner, Antonella Tufano, Silvia Soler, F. Pace, Paolo Prandoni, L. Font, L. Bertoletti, A. García-Raso, G. Pérez-Rus, V. Salazar, Juan I. Arcelus, Barbara Ney, Lauren Cote, Raquel Barba, B. Brandolin, Luciano López-Jiménez, Pierpaolo Di Micco, C. Fernández-Capitán, M. Martín Fernández, M.A. García, R. Barba, R. Valle, Carmen Fernández-Capitán, M.L. Pesce, J.M. Martín-Guerra, D. Farge-Bancel, Conxita Falga, M. Lumbierres, Fernando Uresandi, Benjamin Brenner, Elvira Grandone, Mónica Loring, Dominique Farge-Bancel, A. Lalueza, Cristiano Bortoluzzi, M.J. Núñez, M.C. Olivares, Maurizio Ciammaichella, M.D. Joya, Agustina Rivas, Joan Carles Sahuquillo, C.M. Rubio, Abílio Reis, A. Vilaseca, P. Di Micco, Jana Hirmerova, M. Monreal, José María Pedrajas, M.L. Peris, M.A. Rodríguez-Dávila, S. Otalora, F. Bilora, E. Usandizaga, C. Amado, Pedro Ruiz-Artacho, Roberto Quintavalla, B. Barrón-Andrés, P.M. Azcarate, I. Benzidia, Lucia Mazzolai, P. Gutiérrez, Jorge Lima, O. Gavín, Thomas Vanassche, Farès Moustafa, V. Gómez, Andris Skride, Joseph A. Caprini, A. Gil-Díaz, Behnood Bikdeli, A. Hij, L. Rodríguez-Fernández, Olga Madridano, C. Rodríguez-Martín, C. de Ancos, Ana Maestre, M.C. Fernández-Criado, Henri Bounameaux, M.I. Torres, Radovan Malý, A.I. Farfán, I. Tzoran, J.A. Díaz-Peromingo, J.B. López-Sáez, M. Barrón, C. Tolosa, José Luis Lobo, Francesco Dentali, M. Zdraveska, Marijan Bosevski, L.M. Hernández Blasco, J.A. Nieto, Ma Morales, J. Caprini, Golemi, I., Cote, L., Iftikhar, O., Brenner, B., Tafur, A., Bikdeli, B., Fernandez-Capitan, C., Pedrajas, J. M., Otero, R., Quintavalla, R., Monreal, M., Prandoni, P., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Tzoran, I., Reis, A., Bounameaux, H., Maly, R., Verhamme, P., Bosevski, M., Caprini, J. A., Bui, H. M., Adarraga, M. D., Aibar, M. A., Aibar, J., Amado, C., Arcelus, J. I., Azcarate, P. M., Ballaz, A., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Camon, A. M., Carrasco, C., Castro, J., de Ancos, C., del Toro, J., Demelo, P., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Diaz-Simon, R., Encabo, M., Falga, C., Farfan, A. I., Fernandez-Criado, M. C., Fidalgo, M. A., Font, C., Font, L., Garcia, M. A., Garcia-Bragado, F., Garcia-Morillo, M., Garcia-Raso, A., Gavin, O., Gaya, I., Gayol, M. C., Gil-Diaz, A., Guirado, L., Gomez, V., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Hernandez Blasco, L. M., Iglesias, M., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jou, I., Joya, M. D., Lalueza, A., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P. J., Martin-Guerra, J. M., Martin Fernandez, M., Mellado, M., Morales, M. V., Nieto, J. A., Nunez, M. J., Olivares, M. C., Otalora, S., Pellejero, G., Perez-Pinar, M., Perez-Rus, G., Peris, M. L., Pesce, M. L., Porras, J. A., Rivas, A., Rodriguez-Davila, M. A., Rodriguez-Fernandez, L., Rodriguez-Hernandez, A., Rodriguez-Martin, C., Rubio, C. M., Ruiz-Alcaraz, S., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salazar, V., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Sanoja, I., Soler, S., Soto, M. J., Surinach, J. M., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vidal, G., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Hirmerova, J., Salgado, E., Benzidia, I., Bura-Riviere, A., Debourdeau, P., Falvo, N., Hij, A., Mahe, I., Moustafa, F., Braester, A., Ellis, M., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Dentali, F., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Mumoli, N., Vo Hong, N., Pace, F., Parisi, R., Pesavento, R., Pinelli, M., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Skride, A., Sablinskis, K., Sablinskis, M., Zdraveska, M., Fresa, M., Ney, B., Mazzolai, L., and Caprini, J.
Subjects: Registrie, Male, Time Factors, Databases, Factual, Major adverse cardiovascular event, 030204 cardiovascular system & hematology, Coronary artery disease, 0302 clinical medicine, Retrospective Studie, Cardiovascular Disease, Major adverse limb events, Medicine, Registries, 030212 general & internal medicine, Myocardial infarction, Stroke, Incidence, Incidence (epidemiology), Hazard ratio, Major adverse limb event, Heart Disease Risk Factor, Middle Aged, Prognosis, Cardiovascular Diseases, Major adverse cardiovascular events, Female, VTE, Cardiology and Cardiovascular Medicine, Human, Provoked, Venous thromboembolism, medicine.medical_specialty, Time Factor, Prognosi, Risk Assessment, 03 medical and health sciences, Internal medicine, Humans, cardiovascular diseases, Aged, Retrospective Studies, business.industry, Unstable angina, medicine.disease, equipment and supplies, Confidence interval, Heart Disease Risk Factors, Surgery, business, Mace
Abstract: Registro Informatizado de Enfermedad Tromboembólica Investigators., [Objective] Overlap exists between the risk factors for coronary artery disease and venous thromboembolism (VTE). However, a paucity of data is available on the incidence of major acute cardiovascular events (MACE) and major adverse limb events (MALE) among patients presenting with VTE. Moreover, it is unknown whether the rate of cardiovascular outcomes differs among patients with unprovoked vs provoked VTE., [Methods] We analyzed the data from 2009 to 2017 in the Registro Informatizado de Enfermedad Tromboembólica registry, an ongoing, multicenter, international registry of consecutive patients with a diagnosis of objectively confirmed VTE. The query was restricted it to patients with data entry for the arterial outcomes. The baseline prevalence of coronary artery disease risk factors was compared between patients with provoked (ie, immobility, cancer, surgery, travel >6 hours, hormonal causes) and unprovoked VTE. After the initial VTE event, we followed up patients for the composite primary outcome of incident MACE (ie, stroke, myocardial infarction, unstable angina) and/or MALE (ie, major limb events). We used the χ2 test for baseline associations and a Cox proportional hazard for multivariate analysis. We used IBM SPSS, version 24 (IBM Corp, Armonk, NY) for statistical analysis. A P value of, [Results] We analyzed the data from 41,259 patients with VTE, of whom 22,633 (55.6%) had experienced a provoked VTE. During follow-up, the patients with provoked VTE were more likely to develop MACE or MALE than were patients with unprovoked VTE (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.1-1.5). The association of arterial events with recent immobility (HR, 1.4; 95% CI, 1.5-12.1) and cancer (HR, 1.7; 95% CI, 1.4-1.9) was strong. After adjusting for multiple conventional cardiovascular risk factors, provoked VTE, compared with unprovoked VTE, was significantly associated with an increased hazard for MACE (HR, 1.4; 95% CI, 1.1-1.7). Cancer remained a significant adjusted predictor for both MACE (HR, 1.7; 95% CI, 1.4-2.1) and MALE (HR, 2.1; 95% CI 1.01-4.6) in those with provoked VTE., [Conclusions] Among patients with VTE, provoked cases, specifically those with cancer-associated VTE, have an increased risk of major arterial events.
Published: 2020

28. Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

Author: Jara-Palomares, Luis, Alfonso, Maria, Maestre, Ana, Jimenez, David, Garcia-Bragado, Fernando, Font, Carme, Lopez Reyes, Raquel, Hernandez Blasco, Luis, Vidal, Gemma, Otero, Remedios, Monreal, Manuel, Adarraga, Ma Dolores, Angel Aibar, Miguel, Aibar, Jesus, Amado, Cristina, Ignacio Arcelus, Juan, Ballaz, Aitor, Barba, Raquel, Barron, Manuel, Barron-Andres, Belen, Bascunana, Jose, Blanco-Molina, Angeles, Maria Camon, Ana, Canas, Inmaculada, Carrasco, Cristina, Castro, Joaquin, de Ancos, Cristina, Del Toro, Jorge, Demelo, Pablo, Antonio Diaz-Peromingo, Jose, Diaz-Simon, Raquel, Falga, Conxita, Isabel Farfan, Ana, Fernandez-Capitan, Carmen, Del Carmen Fernandez-Criado, Maria, Fernandez-Nunez, Sandra, Fidalgo, Angeles, Font, Llorenc, Angelina Garcia, Maria, Garcia-Morillo, Marcial, Garcia-Raso, Aranzzu, Gavin-Sebastian, Olga, del Carmen Gayol, Maria, Gil-Diaz, Aida, Gomez, Vicente, Gomez-Cuervo, Covadonga, Gonzalez-Martinez, Jose, Grau, Enric, Gutierrez, Javier, Gutierrez-Gonzalez, Sara, Iglesias, Marina, Jaras, Ma Jesus, Jou, Ines, Dolores Joya, Maria, Lalueza, Antonio, Lima, Jorge, Llamas, Pilar, Luis Lobo, Jose, Lopez-Jimenez, Luciano, Lopez-Miguel, Patricia, Jose Lopez-Nunez, Juan, Bosco Lopez-Saez, Juan, Alejandro Lorente, Manuel, Lorenzo, Alicia, Loring, Monica, Madridano, Olga, Javier Marchena, Pablo, Miguel Martin, Javier, Mellado, Meritxell, del Valle Morales, Ma, Luisa Nieto, Maria, Antonio Nieto, Jose, Jesus Nunez, Manuel, Carmen Olivares, Maria, Maria Pedrajas, Jose, Pellejero, Galadriel, Prez-Rus, Gloria, Peris, Ma Luisa, Antonio Porras, Jose, Rivas, Agustina, Angeles Rodriguez-Davila, Ma, Adela Rodriguez-Hernandez, A, Rubio, Carmen Ma, Ruiz-Artacho, Pedro, Ruiz-Ruiz, Justo, Ruiz-Sada, Pablo, Carles Sahuquillo, Joan, Salazar, Vladimir, Samperiz, Angel, Sanchez Munoz-Torrero, Juan Francisco, Sancho, Teresa, Soler, Silvia, Maria Surinach, Jose, Tapia, Elena, Tolosa, Caries, Isabel Torres, Maria, Trujillo-Santos, Javier, Uresandi, Fernando, Valle, Reina, Villares, Paula, Gutierrez, Paula, Javier Vazquez, Fernando, Vilaseca, Alicia, Vanassche, Thomas, Vandenbriele, Christophe, Verhamme, Peter, Hirmerova, Jana, Maly, Radovan, Celis, Gregory, del Pozo, Gustavo, Salgado, Estuardo, Benzidia, Ilham, Bertoletti, Laurent, Bura-Riviere, Alessandra, Debourdeau, Philippe, Farge-Bancel, Dominique, Hij, Adrian, Mahe, Isabelle, Moustafa, Fares, Schellong, Sebastian, Braester, Andrei, Brenner, Benjamin, Tzoran, Inna, Sharif-Kashani, Babak, Barillari, Giovanni, Bilora, Franca, Bortoluzzi, Cristiano, Brandolin, Barbara, Bucherini, Eugenio, Ciammaichella, Maurizio, Dentali, Francesco, Di Micco, Pierpaolo, Maida, Rosa, Mastroiacovo, Daniela, Mumoli, Nicola, Pace, Federica, Parisi, Roberto, Pesavento, Raffaelle, Prandoni, Paolo, Quintavalla, Roberto, Rocci, Anna, Romualdi, Roberta, Sinicalchi, Carmine, Tufano, Antonella, Visona, Adriana, Hong, Ngoc Vo, Zalunardo, Beniamino, Gibietis, Valdis, Kigitovica, Dana, Skride, Andris, Bosevski, Marijan, Bounameaux, Henri, Mazzolai, Lucia, Caprini, Joseph A, Hanh, My Bui, Khanh, Quoc Pham, Reis, Abilio, UCH. Departamento de Medicina (Extinguido), Producción Científica UCH 2019, UCH. Departamento de Medicina y Cirugía, Sanofi España, Bayer, Sociedad Española de Neumología y Cirugía Torácica, Jara-Palomares, L., Alfonso, M., Maestre, A., Jimenez, D., Garcia-Bragado, F., Font, C., Reyes, R. L., Blasco, L. H., Vidal, G., Otero, R., Monreal, M., Adarraga, M. ªD., Aibar, M. A., Aibar, J., Amado, C., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Camon, A. M., Canas, I., Carrasco, C., Castro, J., de Ancos, C., Del Toro, J., Demelo, P., Diaz-Peromingo, J. A., Diaz-Simon, R., Falga, C., Farfan, A. I., Fernandez-Capitan, C., del Carmen Fernandez-Criado, M., Fernandez-Nunez, S., Fidalgo, A., Font, L., Garcia, M. A., Garcia-Morillo, M., Garcia-Raso, A., Gavin-Sebastian, O., del Carmen Gayol, M., Gil-Diaz, A., Gomez, V., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gutierrez, J., Gutierrez-Gonzalez, S., Iglesias, M., Jaras, M. ªJ., Jou, I., Joya, M. D., Lalueza, A., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Marchena, P. J., Martin, J. M., Mellado, M., Morales, M. ªV., Nieto, M. L., Nieto, J. A., Nunez, M. J., Olivares, M. C., Pedrajas, J. M., Pellejero, G., Perez-Rus, G., Peris, M. ªL., Porras, J. A., Rivas, A., Rodriguez-Davila, M. ªA., Adela Rodriguez-Hernandez, A., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salazar, V., Samperiz, A., Munoz-Torrero, J. F. S., Sancho, T., Soler, S., Surinach, J. M., Tapia, E., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Valle, R., Villares, P., Gutierrez, P., Vazquez, F. J., Vilaseca, A., Vanassche, T., Vandenbriele, C., Verhamme, P., Hirmerova, J., Maly, R., Celis, G., del Pozo, G., Salgado, E., Benzidia, I., Bertoletti, L., Bura-Riviere, A., Debourdeau, P., Farge-Bancel, D., Hij, A., Mahe, I., Moustafa, F., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Sharif-Kashani, B., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Ciammaichella, M., Dentali, F., Di Micco, P., Maida, R., Mastroiacovo, D., Mumoli, N., Pace, F., Parisi, R., Pesavento, R., Prandoni, P., Quintavalla, R., Rocci, A., Romualdi, R., Sinicalchi, C., Tufano, A., Visona, A., Hong, N. V., Zalunardo, B., Gibietis, V., Kigitovica, D., Skride, A., Bosevski, M., Bounameaux, H., Mazzolai, L., Caprini, J. A., Bui, H. M., Pham, K. Q., and Reis, A.
Subjects: PREDICTION, Embolism, Aparato circulatorio - Enfermedades - Pronóstico, Cardiovascular system - Diseases - Prognosis, lcsh:Medicine, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Risk Factors, 030212 general & internal medicine, lcsh:Science, INDEX, education.field_of_study, Multidisciplinary, Middle Aged, Prognosis, Predictive value, Pulmonary embolism, Multidisciplinary Sciences, DERIVATION, Science & Technology - Other Topics, Major bleeding, Human, medicine.medical_specialty, ANTITHROMBOTIC THERAPY, Disease-free survival, Prognosi, Population, DIAGNOSIS, VALIDATION, Article, 03 medical and health sciences, STRATIFICATION, Thromboembolism, Internal medicine, medicine, Humans, In patient, education, Retrospective Studies, OLDER, VENOUS THROMBOEMBOLISM, Science & Technology, business.industry, Risk Factor, lcsh:R, CLINICAL PRESENTATION, Retrospective cohort study, medicine.disease, Embolia pulmonar - Pronóstico, Shock index, Pulmonary embolism - Prognosis, Spain, lcsh:Q, business, Pulmonary Embolism
Abstract: The RIETE investigators., In young patients with acute pulmonary embolism (PE), the predictive value of currently available prognostic tools has not been evaluated. Our objective was to compare prognostic value of 7 available tools (GPS, PESI, sPESI, Prognostic Algorithm, PREP, shock index and RIETE) in patients aged, This study received funding: SEPAR (1/2016) grupo GeCIR. We express our gratitude to Sanofi Spain for supporting this Registry with an unrestricted educational grant. We also wish to thank Bayer Pharma AG for supporting this Registry. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain, which accounts for a 25.20% of the total patients included in the RIETE Registry.
Published: 2019

29. Timing and characteristics of venous thromboembolism after noncancer surgery

Author: Manuela Expósito-Ruiz, Juan Ignacio Arcelus, Joseph A. Caprini, Cristina López-Espada, Alessandra Bura-Riviere, Cristina Amado, Mónica Loring, Daniela Mastroiacovo, Manuel Monreal, Paolo Prandoni, Benjamin Brenner, Dominique Farge-Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Peter Verhamme, Hanh My Bui, M.D. Adarraga, M. Agud, J. Aibar, M.A. Aibar, C. Amado, J.I. Arcelus, C. Baeza, A. Ballaz, R. Barba, C. Barbagelata, M. Barrón, B. Barrón-Andrés, A. Blanco-Molina, E. Botella, A.M. Camon, S. Campos, I. Cañas, I. Casado, J. Castro, J. Criado, C. de Ancos, J. de Miguel, J. del Toro, P. Demelo-Rodríguez, C. Díaz-Pedroche, J.A. Díaz-Peromingo, J. Díez-Sierra, I.M. Domínguez, J.C. Escribano, C. Falgá, A.I. Farfán, K. Fernández de Roitegui, C. Fernández-Aracil, C. Fernández-Capitán, J.L. Fernández-Reyes, M.A. Fidalgo, K. Flores, C. Font, L. Font, I. Francisco, I. Furest, C. Gabara, F. Galeano-Valle, M.A. García, F. García-Bragado, R. García-Hernáez, A. García-Raso, O. Gavín-Sebastián, A. Gil-Díaz, C. Gómez-Cuervo, J. González-Martínez, E. Grau, M. Giménez-Suau, L. Guirado, J. Gutiérrez, L. Hernández-Blasco, E. Hernando, M. Herreros, L. Jara-Palomares, M.J. Jaras, D. Jiménez, R. Jiménez, M.D. Joya, I. Jou, A. Lalueza, R. Lecumberri, J. Lima, P. Llamas, J.L. Lobo, L. López-Jiménez, P. López-Miguel, J.J. López-Núñez, R. López-Reyes, J.B. López-Sáez, A. Lorenzo, M. Loring, O. Madridano, A. Maestre, P.J. Marchena, M. Martín del Pozo, F. Martín-Martos, C. Mella, M. Mellado, M.I. Mercado, J. Moisés, M. Monreal, M.V. Morales, A. Muñoz-Blanco, D. Muñoz-Guglielmetti, N. Muñoz-Rivas, J.A. Nieto, A. Núñez-Ares, M.J. Núñez-Fernández, B. Obispo, M.C. Olivares, J.L. Orcastegui, M.D. Ortega-Recio, J. Osorio, S. Otalora, R. Otero, D. Paredes, P. Parra, V. Parra, J.M. Pedrajas, G. Pellejero, D. Pesántez, J.A. Porras, J. Portillo, A. Riera-Mestre, A. Rivas, F. Rivera, A. Rodríguez-Cobo, C. Rodríguez-Matute, J. Rogado, V. Rosa, C.M. Rubio, P. Ruiz-Artacho, N. Ruiz-Giménez, J. Ruiz-Ruiz, P. Ruiz-Sada, J.C. Sahuquillo, G. Salgueiro, A. Sampériz, J.F. Sánchez-Muñoz-Torrero, T. Sancho, P. Sigüenza, S. Soler, J.M. Suriñach, M.I. Torres, C. Tolosa, J. Trujillo-Santos, F. Uresandi, R. Valle, J.R. Vela, G. Vidal, P. Villares, C. Zamora, P. Gutiérrez, F.J. Vázquez, T. Vanassche, C. Vandenbriele, P. Verhamme, J. Hirmerova, R. Malý, I. Benzidia, L. Bertoletti, A. Bura-Riviere, B. Crichi, P. Debourdeau, O. Espitia, D. Farge-Bancel, H. Helfer, I. Mahé, F. Moustafa, G. Poenou, S. Schellong, A. Braester, B. Brenner, I. Tzoran, F. Bilora, B. Brandolin, E. Bucherini, M. Ciammaichella, D. Colaizzo, P. Di Micco, E. Grandone, D. Marchi, D. Mastroiacovo, R. Maida, F. Pace, R. Pesavento, P. Prandoni, R. Quintavalla, N. Rinzivillo, A. Rocci, C. Siniscalchi, A. Tufano, A. Visonà, B. Zalunardo, V. Gibietis, D. Kigitovica, A. Skride, M. Ferreira, S. Fonseca, F. Martins, J. Meireles, M. Bosevski, G. Krstevski, H. Bounameaux, L. Mazzolai, J.A. Caprini, A.J. Tafur, I. Weinberg, H. Wilkins, H.M. Bui, Exposito-Ruiz, M., Arcelus, J. I., Caprini, J. A., Lopez-Espada, C., Bura-Riviere, A., Amado, C., Loring, M., Mastroiacovo, D., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Verhamme, P., Bui, H. M., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Botella, E., Camon, A. M., Campos, S., Canas, I., Casado, I., Castro, J., Criado, J., de Ancos, C., de Miguel, J., Toro, J. D., Demelo-Rodriguez, P., Diaz-Pedroche, C., Diaz-Peromingo, J. A., Diez-Sierra, J., Dominguez, I. M., Escribano, J. C., Falga, C., Farfan, A. I., Fernandez de Roitegui, K., Fernandez-Aracil, C., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Furest, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Hernaez, R., Garcia-Raso, A., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Gimenez-Suau, M., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Hernando, E., Herreros, M., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, R., Joya, M. D., Jou, I., Lalueza, A., Lecumberri, R., Lima, J., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Munoz-Rivas, N., Nieto, J. A., Nunez-Ares, A., Nunez-Fernandez, M. J., Obispo, B., Olivares, M. C., Orcastegui, J. L., Ortega-Recio, M. D., Osorio, J., Otalora, S., Otero, R., Paredes, D., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Pesantez, D., Porras, J. A., Portillo, J., Riera-Mestre, A., Rivas, A., Rivera, F., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rogado, J., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Siguenza, P., Soler, S., Surinach, J. M., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valle, R., Vela, J. R., Vidal, G., Villares, P., Zamora, C., Gutierrez, P., Vazquez, F. J., Vanassche, T., Vandenbriele, C., Hirmerova, J., Benzidia, I., Crichi, B., Debourdeau, P., Espitia, O., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Braester, A., Bilora, F., Brandolin, B., Bucherini, E., Ciammaichella, M., Colaizzo, D., Grandone, E., Marchi, D., Maida, R., Pace, F., Pesavento, R., Quintavalla, R., Rinzivillo, N., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Zalunardo, B., Gibietis, V., Kigitovica, D., Skride, A., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Krstevski, G., Mazzolai, L., Tafur, A. J., Weinberg, I., and Wilkins, H.
Subjects: Adult, Male, Registrie, medicine.medical_specialty, Time Factors, Time Factor, Duration of risk, 030204 cardiovascular system & hematology, Drug Administration Schedule, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Deep vein thrombosi, Interquartile range, medicine, Humans, Registries, cardiovascular diseases, 030212 general & internal medicine, Aged, Venous Thrombosis, Benign disease, business.industry, Risk Factor, Incidence (epidemiology), Pulmonary embolism, Anticoagulant, Anticoagulants, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, equipment and supplies, medicine.disease, Thrombosis, Surgery, Time course, Thromboprophylaxi, Female, Postoperative Complication, Cardiology and Cardiovascular Medicine, business, Venous thromboembolism, Human, Surgical patients
Abstract: Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.
Published: 2021
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23. Economic evaluation of cereal cropping systems under semiarid conditions: Minimum input, organic and conventional | Avaliação econômica de sistemas de cultivo de cereias em condições semiáridas: Cultivo mínimo, orgânico e convencional

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28. Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

29. Timing and characteristics of venous thromboembolism after noncancer surgery

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