27 results on '"Ten Cate-Hoek, A"'
Search Results
2. Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis
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Kakkos, Stavros K., Gohel, Manjit, Baekgaard, Niels, Bauersachs, Rupert, Bellmunt-Montoya, Sergi, Black, Stephen A., ten Cate-Hoek, Arina J., Elalamy, Ismail, Enzmann, Florian K., Geroulakos, George, Gottsäter, Anders, Hunt, Beverley J., Mansilha, Armando, Nicolaides, Andrew N., Sandset, Per Morten, Stansby, Gerard, ESVS Guidelines Committee, de Borst, Gert J., Bastos Gonçalves, Frederico, Chakfé, Nabil, Hinchliffe, Robert, Kolh, Philippe, Koncar, Igor, Lindholt, Jes S., Tulamo, Riikka, Twine, Christopher P., Vermassen, Frank, Wanhainen, Anders, Document reviewers, De Maeseneer, Marianne G., Comerota, Anthony J., Gloviczki, Peter, Kruip, Marieke J.H.A., Monreal, Manuel, Prandoni, Paolo, and Vega de Ceniga, Melina
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- 2021
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3. Anticoagulation in thrombocytopenic patients with hematological malignancy: A multinational clinical vignette-based experiment
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Leader, Avi, ten Cate, Vincent, ten Cate-Hoek, Arina J, Beckers, Erik A.M., Spectre, Galia, Giaccherini, Cinzia, Gurevich-Shapiro, Anna, Krashin, Eilon, Raanani, Pia, Schouten, Harry C., Falanga, Anna, and ten Cate, Hugo
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- 2020
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4. Anticoagulation in thrombocytopenic patients with hematological malignancy: A multinational clinical vignette-based experiment
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Leader, A, Ten Cate, V, Ten Cate-Hoek, A, Beckers, E, Spectre, G, Giaccherini, C, Gurevich-Shapiro, A, Krashin, E, Raanani, P, Schouten, H, Falanga, A, Ten Cate, H, Leader A, Ten Cate V, Ten Cate-Hoek AJ, Beckers EAM, Spectre G, Giaccherini C, Gurevich-Shapiro A, Krashin E, Raanani P, Schouten HC, Falanga A, Ten Cate H, Leader, A, Ten Cate, V, Ten Cate-Hoek, A, Beckers, E, Spectre, G, Giaccherini, C, Gurevich-Shapiro, A, Krashin, E, Raanani, P, Schouten, H, Falanga, A, Ten Cate, H, Leader A, Ten Cate V, Ten Cate-Hoek AJ, Beckers EAM, Spectre G, Giaccherini C, Gurevich-Shapiro A, Krashin E, Raanani P, Schouten HC, Falanga A, and Ten Cate H
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Background: Thrombocytopenia in cancer patients with an indication for anticoagulation poses a unique clinical challenge. There are guidelines for the setting of venous thromboembolism but not atrial fibrillation (AF). Evidence is lacking and current practice is unclear. Objective: To identify patient and physician characteristics associated with anticoagulation management in hematological malignancy and thrombocytopenia. Methods: A clinical vignette-based experiment was designed. Eleven hematologists were interviewed, identifying 5 relevant variable categories with 2–5 options each. Thirty hypothetical vignettes were generated. Each physician received 5 vignettes and selected a management strategy (hold anticoagulation; no change; transfuse platelets; modify type/dose). The survey was distributed to hematologists and thrombosis specialists in 3 countries. Poisson regression models with cluster robust variance estimates were used to calculate relative risks for using one management option over the other, for each variable in comparison to a reference variable. Results: 168 physicians answered 774 cases and reported continuing anticoagulation for venous thromboembolism or AF in 607 (78%) cases, usually with dose reduction or platelet transfusion support. Overall, management was affected by platelet count, anticoagulation indication, time since indication, type of hematological disease and treatment, and prior major bleeding, as well as physician demographics and practice setting. The CHA2DS2-VASc score and time since AF diagnosis affected anticoagulation management in AF. Conclusion: This study indicates what the widely accepted management strategies are. These strategies, and possibly others, should be assessed prospectively to ascertain effectiveness. The decision process is intricate and compatible with current venous thromboembolism guidelines.
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- 2020
5. Stressful experiences and venous thromboembolism
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ten Cate-Hoek, Arina and ten Cate, Hugo
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- 2024
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6. Anticoagulation in thrombocytopenic patients with hematological malignancy: A multinational clinical vignette-based experiment
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Harry C. Schouten, Avi Leader, Arina J. ten Cate-Hoek, Galia Spectre, Anna Gurevich-Shapiro, Erik A M Beckers, Hugo ten Cate, Cinzia Giaccherini, Pia Raanani, Eilon Krashin, Vincent ten Cate, Anna Falanga, Leader, A, Ten Cate, V, Ten Cate-Hoek, A, Beckers, E, Spectre, G, Giaccherini, C, Gurevich-Shapiro, A, Krashin, E, Raanani, P, Schouten, H, Falanga, A, Ten Cate, H, RS: Carim - B04 Clinical thrombosis and Haemostasis, Interne Geneeskunde, RS: CAPHRI - R5 - Optimising Patient Care, Epidemiologie, MUMC+: HVC Pieken Trombose (9), MUMC+: MA Hematologie (9), RS: Carim - B01 Blood proteins & engineering, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: HVC Trombosezorg (8), MUMC+: MA Alg Interne Geneeskunde (9), and Biochemie
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medicine.medical_specialty ,Hemorrhage ,Disease ,030204 cardiovascular system & hematology ,Disease cluster ,Risk Assessment ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Risk Factors ,Neoplasms ,Atrial Fibrillation ,Internal Medicine ,medicine ,MANAGEMENT ,Humans ,030212 general & internal medicine ,Poisson regression ,Intensive care medicine ,Blood Coagulation ,RISK ,business.industry ,Anticoagulant ,Anticoagulants ,Atrial fibrillation ,medicine.disease ,Thrombosis ,CANCER ,Thrombocytopenia ,Stroke ,Platelet transfusion ,Hematological malignancy ,Relative risk ,Hematologic Neoplasms ,symbols ,Neoplasm ,business ,Venous thromboembolism - Abstract
Background: Thrombocytopenia in cancer patients with an indication for anticoagulation poses a unique clinical challenge. There are guidelines for the setting of venous thromboembolism but not atrial fibrillation (AF). Evidence is lacking and current practice is unclear.Objective: To identify patient and physician characteristics associated with anticoagulation management in hematological malignancy and thrombocytopenia.Methods: A clinical vignette-based experiment was designed. Eleven hematologists were interviewed, identifying 5 relevant variable categories with 2-5 options each. Thirty hypothetical vignettes were generated. Each physician received 5 vignettes and selected a management strategy (hold anticoagulation; no change; transfuse platelets; modify type/dose). The survey was distributed to hematologists and thrombosis specialists in 3 countries. Poisson regression models with cluster robust variance estimates were used to calculate relative risks for using one management option over the other, for each variable in comparison to a reference variable.Results: 168 physicians answered 774 cases and reported continuing anticoagulation for venous thromboembolism or AF in 607 (78%) cases, usually with dose reduction or platelet transfusion support. Overall, management was affected by platelet count, anticoagulation indication, time since indication, type of hematological disease and treatment, and prior major bleeding, as well as physician demographics and practice setting. The CHA(2)DS(2)-VASc score and time since AF diagnosis affected anticoagulation management in AF.Conclusion: This study indicates what the widely accepted management strategies are. These strategies, and possibly others, should be assessed prospectively to ascertain effectiveness. The decision process is intricate and compatible with current venous thromboembolism guidelines.
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- 2020
7. The post thrombotic syndrome: Ignore it and it will come back to bite you.
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ten Cate-Hoek, Arina J., Henke, Peter K., and Wakefield, Thomas W.
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Post thrombotic syndrome (PTS) is a very common chronic complication of deep venous thrombosis (DVT), as three out of ten patients with lower extremity DVT will develop PTS. The possibility to identify patients at risk is limited. Diagnosis is challenging, because there is no gold standard diagnostic method. Progress in diagnostic options may therefore change future diagnostic strategies. The better understanding of pathophysiologic processes that underlie PTS may stimulate the development of treatment modalities and improve and diversify management options. The quest for adequate preventive strategies and treatment is important because PTS has a detrimental effect on patients' quality of life and is associated with increased healthcare as well as societal costs. [1,2] The problem of PTS prevention is therefore clearly relevant to patients, doctors as well as policy makers. [ABSTRACT FROM AUTHOR]
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- 2016
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8. Venous In-stent Thrombosis Treated by Ultrasound Accelerated Catheter Directed Thrombolysis.
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Strijkers, R.H.W., de Wolf, M.A.F., Arnoldussen, C.W.K.P., Timbergen, M.J.M., de Graaf, R., Ten Cate-Hoek, A.J., and Wittens, C.H.A.
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Objective/Background Stent placement in the venous system is an increasingly used treatment modality in chronic venous obstruction and as additional treatment after thrombolytic therapy in ilio-femoral deep vein thrombosis (DVT). Experience in treating in-stent thrombosis with ultrasound accelerated catheter directed thrombolysis (UACDT) is reported. Methods A retrospective analysis of patients treated for venous stent occlusion, after percutaneous transluminal angioplasty (PTA) and stent placement for either chronic venous occlusive disease or persistent vein compression in patients with acute DVT was performed. Duration of occlusion and suspected clot age were assessed using patient complaints and typical findings on duplex ultrasonography (DUS). DUS and venography were used to assess patency and to determine the cause of re-occlusion. Acute treatment of occlusion was by UACDT. Additional procedures included PTA, stent placement, and creation of an arteriovenous (AV) fistula. Results Eighteen patients (median age 43 years; 67% male), treated for occluded stent tracts with UACDT between January 2009 and July 2014, were identified. Indications for initial stenting were treatment of chronic venous obstructive disease (12 patients) and treatment of underlying obstruction after initial thrombolysis in acute DVT (six patients). Technical success was achieved in 11/18 (61%) patients. Primary patency in 8/11 patients was 73% at last follow up (median follow up 14 months [range 0–41 months]). Additional treatments after successful lysis were re-stenting (seven patients) and creation of an AV fistula (six patients). Conclusion Treatment with UACDT of recently occluded stent tracts is feasible and effective. Recanalization of the stent tract can be achieved in most cases. Additional interventions were frequently used after successful UACDT treatment. Suboptimal stent positioning caused the majority of the stent occlusions. [ABSTRACT FROM AUTHOR]
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- 2015
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9. Venous stenting after deep venous thrombosis and antithrombotic therapy: A systematic review.
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Eijgenraam, Pieter, ten Cate, Hugo, and ten Cate-Hoek, Arina J.
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SYSTEMATIC reviews ,POSTTHROMBOTIC syndrome ,HEMORRHAGE treatment ,ANTICOAGULANTS ,PLATELET aggregation inhibitors ,THERAPEUTICS - Abstract
Introduction Over the last years venous stent placement after deep venous thrombosis (DVT) in the iliofemoral veins has gained more attention. The majority of studies evaluating the safety and efficacy of this intervention are of poor methodological quality and the association with antithrombotic therapy has not been studied explicitly. We performed a systematic review to summarize the available literature on antithrombotic management in relation to the safety and efficacy of venous stenting. Methods We performed a Medline search to identify studies that addressed anticoagulation and/or antiplatelet treatment options after venous stenting in patients with a prior DVT in the iliofemoral area. We identified 192 articles and finally selected 14 articles for use in this review. Results In 86% (12/14) of the included studies anticoagulation was administered to all patients who underwent iliac venous stenting. In 33% of the studies patients received antiplatelet therapy consisting of aspirin and/or clopidogrel (4/12). The duration of antithrombotic treatment was not guided by the stenting procedure in 93% (13/14) of studies. The incidence of re-thrombosis in (sub) groups of only stented patients, ranged from 5% to 25%. Primary, assisted primary, and secondary patency rates 12 months after stent placement ranged from 54%, 72%, 83% respectively to 78%, 83%, 95% in (sub)groups of only stented patients. Rates of major bleedings during long term follow-up ranged from 0% to11%. Conclusion Antithrombotic therapy does not seem to influence any of the outcomes in patients with venous stenting after DVT: recurrent DVT, patency, post-thrombotic syndrome or restenosis and bleeding. [ABSTRACT FROM AUTHOR]
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- 2014
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10. Individually tailored duration of elastic compression therapy in relation to incidence of the postthrombotic syndrome.
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ten Cate-Hoek, Arina J., ten Cate, Hugo, Tordoir, Jan, Hamulyák, Karly, and Prins, Martin H.
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VENOUS thrombosis treatment ,COMPRESSION therapy ,VENOUS insufficiency ,SYNDROMES ,DUPLEX ultrasonography ,TREATMENT duration - Abstract
Objective: We assessed whether individualized shortened duration of elastic compression stocking (ECS) therapy after acute deep venous thrombosis (DVT) is feasible without increasing the incidence of postthrombotic syndrome (PTS). Methods: At the outpatient clinic of the Maastricht University Medical Centre, 125 consecutive patients with confirmed proximal DVT were followed for 2 years. Villalta scores were assessed on four consecutive visits; 3, 6, 12, and 24 months after the acute event. Reflux was assessed once by duplex testing. After 6 months, patients with scores ≤4 on the Villalta clinical score and in the absence of reflux were allowed to discontinue ECS therapy. If reflux was present, two consecutive scores ≤4 were needed to discontinue ECS therapy. Results: ECS therapy was discontinued in 17% of patients at 6 months, in 48% at 12 months, and in 50% at 24 months. Reflux on duplex testing was present in 74/101 (73.3%) tested patients and was not associated with the onset of PTS. At the 6-month visit, the cumulative incidence of PTS was 13.3%, at 12 months 17.0%, and at 24 months 21.1%. Varicosities/venous insufficiency (present at baseline) was significantly associated with PTS; hazard ratio 3.2 (1.2-9.1). Conclusions: Patients with a low probability for developing PTS can be identified as early as 6 months after the thrombotic event, and individualized shortened duration of ECS therapy based on Villalta clinical scores may be a safe management option. These findings need to be confirmed in a randomized clinical trial. [Copyright &y& Elsevier]
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- 2010
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11. Low molecular weight heparins in cancer: Management and prevention of venous thromboembolism in patients with malignancies
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ten Cate-Hoek, Arina J. and Prins, Martin H.
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CANCER treatment , *CANCER hospitals , *ALTERNATIVE treatment for cancer , *DIET therapy for cancer patients , *GENE therapy , *CANCER hormone therapy - Abstract
Abstract: Management and prevention of venous thromboembolism (VTE) in cancer patients is challenging. Not only is the risk of VTE in cancer patients elevated compared to patients without malignancies, but also is standard treatment based on Vitamin K antagonists (VKAs) less effective and associated with an increased frequency of major bleeding. Therapy with Low Molecular Weight Heparin (LMWH) is less sensitive to drug interactions, not hindered by a narrow therapeutic window and needs no monitoring. LMWH therapy therefore seems more practical and may also be more effective in cancer patients. Moreover a possible survival benefit has been suggested, the underlying mechanism of which is not yet unraveled. A combination of cancer and thrombosis is a predictor of poor long-term survival. Anticoagulant drugs, especially LMWH, may be of influence on tumor progression. Hypercoagulability in cancer patients may indicate an aggressive change in the tumor and is associated with tumor progression. Hypercoagulability could on the other hand also be a risk factor for developing cancer. To assist clinicians in defining the role of LMWH in cancer patients, we categorized, summarized and critically weighed all available evidence on the subject. Based on available data derived from clinical trials recommendations on the application of heparin in oncological patients are made. However, many uncertainties remain regarding the subject of cancer related thrombosis in view of treatment and the possible effects on tumor biology by heparins. [Copyright &y& Elsevier]
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- 2008
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12. Maastricht Consensus Conference on Thrombosis (MCCT): A roadmap for future research, February 11-13, 2015, Maastricht, The Netherlands.
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ten Cate-Hoek, Arina J., ten Cate, Hugo, Henskens, Yvonne, van der Meijden, Paola E.J., Spronk, Henri M.H., and Wittens, Cees
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THROMBOSIS , *MEDICAL periodicals , *PERIODICAL publishing , *PUBLISHING - Published
- 2015
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13. Theme 3: Non-invasive management of (recurrent) venous thromboembolism (VTE) and post thrombotic syndrome (PTS).
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ten Cate-Hoek, Arina J., Weitz, Jeffrey I., Gailani, David, Meijer, Karina, Philippou, Helen, Bouman, Annemieke C., Whitney Cheung, Y., van Mens, Thijs E., Govers-Riemslag, Jose W., Vries, Minka, Bleker, Suzanne, Biedermann, Jossi S., Stoof, S. Carina M., and Buller, Harry R.
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NONINVASIVE diagnostic tests , *THROMBOEMBOLISM , *DISEASE relapse , *POSTTHROMBOTIC syndrome , *MEDICAL periodicals - Published
- 2015
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14. Plasma protein signatures for high on-treatment platelet reactivity to aspirin and clopidogrel in peripheral artery disease.
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Baidildinova, G., Pallares Robles, A., ten Cate, V., Kremers, B.M.M., Heitmeier, S., ten Cate, H., Mees, B.M.E., Spronk, H.M.H., Wild, P.S., ten Cate-Hoek, A.J., and Jurk, K.
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PERIPHERAL vascular diseases , *BLOOD proteins , *ASPIRIN , *CLOPIDOGREL , *RANDOM forest algorithms - Abstract
A significant proportion of patients with peripheral artery disease (PAD) displays a poor response to aspirin and/or the platelet P2Y 12 receptor antagonist clopidogrel. This phenomenon is reflected by high on-treatment platelet reactivity (HTPR) in platelet function assays in vitro and is associated with an increased risk of adverse cardiovascular events. This study aimed to elucidate specific plasma protein signatures associated with HTPR to aspirin and clopidogrel in PAD patients. Based on targeted plasma proteomics, 184 proteins from two cardiovascular Olink panels were measured in 105 PAD patients. VerifyNow ASPI- and P2Y 12 -test values were transformed to a continuous variable representing HTPR as a spectrum instead of cut-off level-defined HTPR. Using the Boruta random forest algorithm, the importance of 3 plasma proteins for HTPR in the aspirin, six in clopidogrel and 10 in the pooled group (clopidogrel or aspirin) was confirmed. Network analysis demonstrated clusters with CD84, SLAMF7, IL1RN and THBD for clopidogrel and with F2R, SELPLG, HAVCR1, THBD, PECAM1 , TNFRSF10B, MERTK and ADM for the pooled group. F2R, TNFRSF10B and ADM were higher expressed in Fontaine III patients compared to Fontaine II, suggesting their relation with PAD severity. A plasma protein signature, including eight targets involved in proatherogenic dysfunction of blood cell-vasculature interaction, coagulation and cell death, is associated with HTPR (aspirin and/or clopidogrel) in PAD. This may serve as important systems-based determinants of poor platelet responsiveness to aspirin and/or clopidogrel in PAD and other cardiovascular diseases and may contribute to identify novel treatment strategies. [Display omitted] • A spectrum of high on-treatment platelet reactivity (HTPR) was established for PAD. • HTPR-associated plasma protein signatures differ between aspirin and clopidogrel. • Pooled HTPR relates to PSGL1, PECAM1, TM, PAR1, TRAILR2, ADM, KIM1 and MERTK. • Higher plasma levels of PAR1, TRAILR2 and ADM are associated with PAD severity. • Systems-based plasma protein signatures may determine antiplatelet therapy response. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Individually Tailored Elastic Compression Therapy for the Prevention of Post Thrombotic Syndrome.
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Bouman, A.C., ten Cate-Hoek, A.J., ten Cate, H., and Joore, M.A.
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- 2013
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16. Unsupervised clustering of venous thromboembolism patients by clinical features at presentation identifies novel endotypes that improve prognostic stratification.
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Pallares Robles, Alejandro, ten Cate, Vincent, Lenz, Michael, Schulz, Andreas, Prochaska, Jürgen H., Rapp, Steffen, Koeck, Thomas, Leineweber, Kirsten, Heitmeier, Stefan, Opitz, Christian F., Held, Matthias, Espinola-Klein, Christine, Lackner, Karl J., Münzel, Thomas, Konstantinides, Stavros V., ten Cate-Hoek, Arina, ten Cate, Hugo, and Wild, Philipp S.
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THROMBOEMBOLISM , *SYMPTOMS , *OLDER people , *HIERARCHICAL clustering (Cluster analysis) , *BLOOD proteins - Abstract
Individuals with acute venous thromboembolism (VTE) constitute a heterogeneous group of patients with diverse clinical characteristics and outcome. To identify endotypes of individuals with acute VTE based on clinical characteristics at presentation through unsupervised cluster analysis and to evaluate their molecular proteomic profile and clinical outcome. Data from 591 individuals from the Genotyping and Molecular phenotyping of Venous thromboembolism (GMP-VTE) project were explored. Hierarchical clustering was applied to 58 variables to define VTE endotypes. Clinical characteristics, three-year incidence of thromboembolic events or death, and acute-phase plasma proteomics were assessed. Four endotypes were identified, exhibiting different patterns of clinical characteristics and clinical course. Endotype 1 (n = 300), comprising older individuals with comorbidities, had the highest incidence of thromboembolic events or death (HR [95 % CI]: 3.76 [1.96–7.19]), followed by endotype 4 (n = 127) (HR [95 % CI]: 2.55 [1.26–5.16]), characterised by men with history of VTE and provoking risk factors, and endotype 3 (n = 57) (HR [95 % CI]: 1.57 [0.63–3.87]), composed of young women with provoking risk factors, vs. reference endotype 2 (n = 107). The reference endotype was constituted by individuals diagnosed with PE without comorbidities, who had the lowest incidence of the investigated endpoint. Differentially expressed proteins associated with the endotypes were related to distinct biological processes, supporting differences in molecular pathophysiology. The endotypes had superior prognostic ability compared to existing risk stratifications such as provoked vs unprovoked VTE and D-dimer levels. Four endotypes of VTE were identified by unsupervised phenotype-based clustering that diverge in clinical outcome and plasmatic protein signature. This approach might support the future development of individualized treatment in VTE. [Display omitted] • Unsupervised clustering of clinical features identified four endotypes in acute VTE. • Endotypes differed in recurrence of VTE, arterial events, death and bleeding. • Plasma protein profiling by immuno-PCR suggests pathomechanistic diversity. • The endotyping outperformed traditional tools for VTE risk stratification. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Translational insights into mechanisms underlying residual venous obstruction and the role of factor XI, P-selectin and GPVI in recurrent venous thromboembolism.
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Iding, A.F.J., Kremers, B.M.M., Nagy, M., Pallares Robles, A., ten Cate, H., Spronk, H.M.H., and ten Cate-Hoek, A.J.
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THROMBOEMBOLISM , *VENOUS thrombosis , *BLOOD platelet activation , *BLOOD coagulation factor VIII , *DISEASE relapse - Abstract
Residual venous obstruction (RVO) after deep vein thrombosis (DVT) is considered a risk factor of recurrent venous thromboembolism (VTE), arterial events and post-thrombotic syndrome (PTS). We hypothesized thrombo-inflammatory markers might be associated with RVO and clinical outcomes. In a DVT cohort with routine RVO-assessment and 5-year follow-up, patients were invited for blood withdrawal after stopping anticoagulants. Thrombin generation potential, coagulation enzyme:inhibitor complexes, soluble platelet markers and clinical markers were measured in platelet-poor plasma. Associations were represented as odds ratio (OR) or hazard ratio (HR) per standard deviation. Patients with RVO (102/306, 33 %) had higher rates of PTS (24 vs. 12 %, p = 0.008), but similar rates of recurrence (16 vs. 15 %, p = 0.91) and arterial events (7 vs. 4 %, p = 0.26). RVO was associated with thrombin peak height (OR 1.40 [1.04–1.88]), endogenous thrombin potential (ETP, OR 1.35 [1.02–1.79]), and CRP (OR 1.74 [1.10–2.75]). Recurrent VTE was associated with ETP (HR 1.36 [1.03–1.81]), FXIa:C 1 -inhibitor (HR 1.34 [1.04–1.72]), thrombin:antithrombin (HR 1.36 [1.16–1.59]), soluble P-selectin (HR 2.30 [1.69–3.11]), soluble glycoprotein VI (sGPVI, HR 1.30 [1.01–1.69]), D-dimer (HR 1.56 [1.31–1.86]), and factor VIII (HR 1.44 [1.15–1.82]). Arterial events were associated with sGPVI (HR 1.80 [1.25–2.59]). PTS was not associated with any marker. Our findings indicate RVO was associated with thrombo-inflammation, but this did not predict clinical outcomes in this setting. Importantly, we found recurrent VTE was associated with ongoing coagulation and platelet activation in patients well beyond the acute phase of DVT. Furthermore, sGPVI indicated an increased risk of arterial events, highlighting the role of platelets in arterial thrombosis following DVT. [Display omitted] • RVO was associated with TG and CRP, but not with active thrombo-inflammation. • Activated factor XI and P-selectin levels were predictive of recurrent VTE. • GPVI levels were predictive of both venous and arterial thrombotic events. [ABSTRACT FROM AUTHOR]
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- 2023
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18. Exploring the Feasibility of Comprehensive Uncertainty Assessment in Health Economic Modeling: A Case Study.
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Petersohn, Svenja, Grimm, Sabine E., Ramaekers, Bram L.T., ten Cate-Hoek, Arina J., and Joore, Manuela A.
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ECONOMIC models , *UNCERTAINTY , *PERIPHERAL vascular diseases , *EXPERTISE , *MEDICAL quality control , *PILOT projects , *ECONOMICS , *QUALITY assurance , *COST effectiveness - Abstract
Objectives: Decision makers adopt health technologies based on health economic models that are subject to uncertainty. In an ideal world, these models parameterize all uncertainties and reflect them in the cost-effectiveness probability and risk associated with the adoption. In practice, uncertainty assessment is often incomplete, potentially leading to suboptimal reimbursement recommendations and risk management. This study examines the feasibility of comprehensive uncertainty assessment in health economic models.Methods: A state transition model on peripheral arterial disease treatment was used as a case study. Uncertainties were identified and added to the probabilistic sensitivity analysis if possible. Parameter distributions were obtained by expert elicitation, and structural uncertainties were either parameterized or explored in scenario analyses, which were model averaged.Results: A truly comprehensive uncertainty assessment, parameterizing all uncertainty, could not be achieved. Expert elicitation informed 8 effectiveness, utility, and cost parameters. Uncertainties were parameterized or explored in scenario analyses and with model averaging. Barriers included time and resource constraints, also of clinical experts, and lacking guidance regarding some aspects of expert elicitation, evidence aggregation, and handling of structural uncertainty. The team's multidisciplinary expertise and existing literature and tools were facilitators.Conclusions: While comprehensive uncertainty assessment may not be attainable, improvements in uncertainty assessment in general are no doubt desirable. This requires the development of detailed guidance and hands-on tutorials for methods of uncertainty assessment, in particular aspects of expert elicitation, evidence aggregation, and handling of structural uncertainty. The issue of benefits of uncertainty assessment versus time and resources needed remains unclear. [ABSTRACT FROM AUTHOR]- Published
- 2021
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19. Predictive value of D-dimer testing for the diagnosis of venous thrombosis in unusual locations: A systematic review.
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Ordieres-Ortega, L., Demelo-Rodríguez, P., Galeano-Valle, F., Kremers, B.M.M., ten Cate-Hoek, A.J., and ten Cate, H.
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VENOUS thrombosis , *META-analysis , *CEREBRAL veins , *CEREBRAL embolism & thrombosis , *FIBRIN fragment D - Abstract
The value of D-dimer testing for the diagnosis of thrombosis in unusual sites is not properly established and evidence is scarce. We performed a systematic review of the literature. The search was conducted in MEDLINE and Cochrane Library for papers published in the last 10 years including different presentations of thrombosis in unusual sites. Twenty-three articles were included, from January 1, 2008, to December 31, 2018, comprising 3378 patients with thrombosis in unusual sites (upper extremity deep vein thrombosis, cerebral vein thrombosis and splanchnic vein thrombosis). The Newcastle-Ottawa scale was used to assess the quality of the studies. Two articles were related to upper extremity thrombosis, showing a high sensitivity and negative predictive value for D-dimer testing. Twelve articles concerned cerebral vein thrombosis, concluding that the timing of D-dimer testing was important, and that patients with a shorter duration of symptoms showed higher D-dimer levels. Sensitivity and specificity in these patients ranged from 58% to 97% and from 77% to 97.5%, respectively. Nine articles were related to splanchnic vein thrombosis. One described a population of patients with mesenteric venous thrombosis, and the rest included patients with portal vein thrombosis. The D-dimer testing methods and the proposed cut-off levels were remarkably different among the included studies. D-dimer testing should not be currently recommended for the diagnosis of thrombosis in unusual sites as a first line diagnostic tool. The development of algorithms combining biomarkers such as D-dimer and clinical decision tools could improve the diagnosis. • D-dimer testing for the diagnosis of venous thrombosis in unusual sites is controversial. • Upper extremity, cerebrum and abdomen are unusual sites of venous thrombosis. • There is the need for the standardization in D-dimer tests and cutoff levels. • D-dimer combined with a clinical decision rule may be useful for the diagnosis of upper extremity deep vein thrombosis. • The usefulness of D-dimer is still debatable in cerebral vein thrombosis and splanchnic vein thrombosis. [ABSTRACT FROM AUTHOR]
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- 2020
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20. Leukocyte gene expression in post-thrombotic syndrome.
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Iding, Aaron F.J., Witten, Anika, Isaacs, Aaron, Castoldi, Elisabetta, ten Cate, Hugo, Stoll, Monika, and ten Cate-Hoek, Arina J.
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POSTTHROMBOTIC syndrome , *GENE expression , *LEUCOCYTES , *VENOUS thrombosis , *THROMBOTIC thrombocytopenic purpura - Abstract
[Display omitted] • First transcriptomics study performed in the field of post-thrombotic syndrome • Patients with post-thrombotic syndrome have different leukocyte gene expression. • Novel candidate biomarkers of post-thrombotic syndrome were identified. [ABSTRACT FROM AUTHOR]
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- 2021
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21. Toll-like receptor 9 gene expression in the post-thrombotic syndrome, residual thrombosis and recurrent deep venous thrombosis: A case-control study.
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Cheung, Y. Whitney, Bouman, Annemieke C., Castoldi, Elisabetta, Wielders, Simone J., Spronk, Henri M.H., ten Cate, Hugo, ten Cate-Hoek, Arina J., and ten Wolde, Marije
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TOLL-like receptors , *GENE expression , *POSTTHROMBOTIC syndrome , *VENOUS thrombosis , *MESSENGER RNA , *LEUCOCYTES , *DEHYDROGENASES - Abstract
Objective Animal models suggest that toll-like receptor 9 (TLR9) promotes thrombus resolution after acute deep venous thrombosis (DVT). We hypothesized that TLR9 expression is lower in patients with post-thrombotic syndrome (PTS) and investigated the role of TLR9 in residual thrombosis (RT) and recurrence. Methods Patients with a history of DVT with PTS (cases, n = 30) and without PTS after minimal 24 months follow-up (controls, n = 30) were selected. Healthy individuals (HI, n = 29) without DVT were included as reference. TLR9 mRNA expression in leukocytes was determined by qPCR and normalized to the housekeeping succinate dehydrogenase subunit A gene using the ΔCt method. Sub analyses were performed to explore the TLR9 expression in patients with and without RT and multiple DVT episodes. Results The median TLR9 expression was 0.45 (interquartile range 0.31 to 0.93), 0.39 (0.25 to 0.69) and 0.62 (0.32 to 0.75) in cases, controls and HI respectively (p = 0.61). The median TLR9 expression was 0.39 (0.26 to 0.51) in patients with RT compared to 0.55 (0.30 to 0.86, p = 0.13) in those without. The median TLR9 expression was significantly lower in patients who had one DVT compared to patients with recurrent DVT, 0.37 (0.23 to 0.63) versus 0.55 (0.43 to 0.96) respectively (p < 0.01). Conclusion No significant difference in TLR9 expression was found between cases, controls and HI. However TLR9 expression seems lower in individuals with DVT and RT, albeit not significant. Interestingly, TLR9 might play a role in recurrent DVT, as the TLR9 expression was significantly higher in patients with recurrent DVT. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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22. Effects of peri-operative bridging with low molecular weight heparins on coagulation during interruption of vitamin K antagonists: A mechanistic study.
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Eijgenraam, Pieter, ten Cate, Hugo, Henskens, Yvonne, van den Ham, Rene, and ten Cate-Hoek, Arina
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HEPARIN , *BLOOD coagulation factors , *VITAMIN K , *THROMBIN , *THROMBOMODULIN , *SCIENTIFIC observation - Abstract
Background Bridging with low molecular weight heparins (LMWH) is used in patients undergoing invasive procedures that require interruption of vitamin K antagonists (VKA). Little is known on the mechanisms underlying observed thrombotic and bleeding events. In this exploratory study we investigated the interactive effects of the co-administration of VKA, LMWH and surgery on coagulation. Materials and methods Blood was sampled daily from day − 3 to day + 5 in 13 patients. In addition to measurement of INR, anti-Xa activity, thrombin generation (TG) testing and assessment of its protein determinants was performed. Results At the time of intervention the mean INR was 1.0 (SD 0.1, range 0.9–1.2); the mean residual anti-Xa level was 0.19 units/ml (SD 0.20 units/ml, range < 0.05–0.60). The intervention caused a 2–3 fold increase in TG at day 0. Factor (F) XI had the strongest correlation with TG (peak and endogenous thrombin potential (ETP)) ( r = 0.6; p = 0.02). Thrombomodulin-induced reduction of ETP increased from 10.0% (SD 9.2) at day − 3 to 18.2% (SD 9.5) at day 0, p = 0.02. After surgery, FVIII (175.9%(SD 58.9% to 246.7% (SD 71.4%); p = 0.002) and fibrinogen (4.3 g/L (SD 1.1 g/L) to 5.6 g/L (SD 1.7 g/L); p = 0.003) were significantly increased. Conclusions Residual anti-Xa activity was present in 84.6% of patients at the day of the intervention. Three prothrombotic mechanisms were exposed: FXI dependent TG, reduced activity of the activated protein C pathway and postoperative rises in FVIII and fibrinogen. For the perioperative management the value of TG merits further study. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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23. Clot structure and fibrinolytic potential in patients with post thrombotic syndrome.
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Bouman, A. C., McPherson, H., Cheung, Y. W., ten Wolde, M., ten Cate, H., Ariëns, R. A. S., and ten Cate-Hoek, A. J.
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FIBRINOLYTIC agents , *THROMBOEMBOLISM , *ENZYME-linked immunosorbent assay , *FIBRINOGEN , *DISEASE relapse , *PATIENTS - Abstract
Introduction: Post-thrombotic syndrome (PTS) is a chronic sequel of deep vein thrombosis (DVT). The clot structure and fibrinolytic potential in PTS is currently unknown. Objective: To assess the fibrinolytic potential and clot structure in patients with PTS. Materials and methods: Patients with a history of DVT were included in a case-control study: patients with PTS (cases n = 30) and without PTS (controls n = 30), and 30 apparently healthy individuals (HI) without venous thromboembolism (VTE) or venous insufficiency were enrolled. Fibrinolysis and clot structure were assessed by turbidimetric assays, permeation, and confocal microscopy. Fibrinogen was measured by Clauss and fibrinogen γ' by ELISA. Results: We observed a significant trend of decreasing maximum turbidity from HI (median 0.52 [IQR 0.46-0.62]), to controls (0.49 [IQR 0.41-0.55]), to cases (0.46 [IQR 0.39-0.49]) p=0.020. Fibrinogen was lower in patients (cases and controls) (3.69 g/L [IQR 3.31-4.26]) compared to HI (4.17 [IQR 3.69-4.65]) p=0.041. Patients with recurrent VTE had lower maximum turbidity and lower permeation than patients with one episode of VTE; (0.31 [IQR 0.25-0.39] versus 0.38 [IQR 0.34-0.44] p = 0.008) and (6.0 x 10-9/cm² [IQR 5.1-7.9] versus 7.7 x 10-9/cm² [IQR 6.0-10.0] p = 0.047) respectively, at equal fibrinogen levels. There were no differences in lysis time, confocal microscopy, or fibrinogen γ'. Conclusions: Lower maximum turbidity, indicating a tendency towards thinner fibres and denser clots, was found in patients with PTS as well as in patients with recurrent VTE. Fibrinogen levels did not explain these differences in clot structure. The abnormal clot structure may contribute to the increased thrombotic risk profile in patients with PTS. [ABSTRACT FROM AUTHOR]
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- 2016
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24. Distribution, genetic and cardiovascular determinants of FVIII:c -- Data from the population-based Gutenberg Health Study.
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Hermanns, M. Iris, Grossmann, Vera, Spronk, Henri M. H., Schulz, Andreas, Jünger, Claus, Laubert-Reh, Dagmar, Mazur, Johanna, Gori, Tommaso, Zeller, Tanja, Pfeiffer, Norbert, Beutel, Manfred, Blankenberg, Stefan, Münzel, Thomas, Lackner, Karl J., ten Cate-Hoek, Arina J., ten Cate, Hugo, and Wild, Philipp S.
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CARDIOVASCULAR diseases , *DATA analysis , *HEALTH surveys , *VENOUS thrombosis , *EPIDEMIOLOGY - Published
- 2015
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25. The effect of clinical decision support on adherence to thrombosis prophylaxis guidelines in medical patients; A single center experience.
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Eijgenraam, Pieter, Meertens, Nathalie, van den Ham, René, ten Cate, Hugo, and ten Cate-Hoek, Arina J.
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THROMBOSIS , *MEDICAL decision making , *THROMBOEMBOLISM , *MOLECULAR weights , *DECISION support systems , *PATIENTS - Abstract
Venous thromboembolism (VTE) is an underestimated health problem. The administration of low molecular weight heparins (LMWH) to the appropriate patients dramatically decreases VTE incidence. Clinical decision support (CDS) might contribute to thrombosis prophylaxis guideline adherence. Methods A computerized integrated risk score program was used to estimate VTE and bleeding risk of nonsurgical patients. A VTE risk score of ≥4 resulted in an advice to administer LMWH. We selected 64 medical patients before the introduction of CDS (T0) and 64 patients after the introduction (T1). We compared guideline compliance between these groups using chi2 tests. Results No difference between groups was found; Adherence to the guidelines at T0 was 59.4%, the same percentage of 59.4% was found at T1. To evaluate the effect of the introduction of CDS in terms of under and overtreatment we compared the prevalence of over and under treatment at T1 and T0. The OR for receiving under treatment at T1 compared to T0 is 0.48 (95% CI: 0.18-1.30), p=0.14. The OR for overtreatment at T1 compared to T0 is 1.66 (95% CI: 0.74-3.73), p=0.22 Conclusion We found no improvement in guideline adherence towards anti thrombotic prophylaxis in medical patients after the introduction of CDS in this pilot study. There was however a non-significant shift towards over treatment. Possible explanations for these results are the increased awareness of the risk for thromboembolism induced by the study, suboptimal use of CDS and deviation from CDS advice caused by patient's preferences. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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26. Biomarkers for post thrombotic syndrome: A case-control study.
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Bouman, A. C., Cheung, Y. W., Spronk, H. M., Schalkwijk, C. G., ten Cate, H., ten Wolde, M., and ten Cate-Hoek, A. J.
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BIOMARKERS , *POSTTHROMBOTIC syndrome , *CASE-control method , *ETIOLOGY of diseases , *INFLAMMATION , *FOLLOW-up studies (Medicine) , *OUTPATIENT medical care , *DIAGNOSIS - Abstract
There is limited knowledge on the etiology of post thrombotic syndrome (PTS), although several mechanisms have been proposed. The objectives are to explore the role of different pathogenic mechanisms for PTS, through measurement of an elaborate panel of biomarkers in patients with and without PTS. Materials and Methods Patients with a history of deep vein thrombosis (DVT) with PTS (cases) and without PTS after minimal 2years follow-up (controls), were selected from the outpatient clinic of two Dutch hospitals. As a reference to the normal population healthy individuals (HI) without a history of venous thromboembolism were invited to participate. The population consisted of: 26 cases, 27 controls, and 26 HI. A panel of predefined biomarkers was measured in venous blood. Results D-dimer showed a decreasing trend from cases to controls to HI; p=0.010. Thrombin/antithrombin complex levels were significantly higher in cases than in controls; p=0.032, and HI; p=0.017. APC-ratio was significantly lower in cases compared to controls; p=0.032, and HI; p=0.011. A significant trend of increasing proTAFI from cases, to controls, and HI; p=0.002 was found. There were no differences in inflammatory markers (CRP, Interleukin-6, Interleukin-8). Thrombomodulin, tissue-plasminogen activator, and von Willebrand factor were higher in patients compared to HI. There was a significant trend of decreasing sVCAM, from cases, to controls, and HI; p=0.029. Conclusions Patients with PTS displayed increased coagulation activity, an altered pattern of fibrinolytic marker expression, and increased endothelial activation. We found no evidence of systemic inflammation in patients with PTS at 63months since the last DVT. [ABSTRACT FROM AUTHOR]
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- 2014
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27. PCV34 RIVAROXABAN PLUS ASPIRIN FOR THE PREVENTION OF ISCHEMIC EVENTS IN PATIENTS WITH CARDIOVASCULAR DISEASE.
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Petersohn, S., Pouwels, X., Ramaekers, B., ten Cate-Hoek, A., and Joore, M.
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ASPIRIN , *RIVAROXABAN , *CARDIOVASCULAR diseases - Abstract
Preventive treatment of coronary artery disease (CAD) and peripheral arterial disease (PAD) patients with rivaroxaban plus aspirin reduces the occurrence of cardiovascular events but increases treatment costs and bleeding risk compared to aspirin alone. The cost-effectiveness of 2.5mg rivaroxaban twice daily plus 100mg aspirin once daily was compared with 100mg aspirin alone in CAD and PAD patients, and with 75mg clopidogrel in PAD patients. Subgroup analyses showed ICERs below €20,000 for younger CAD patients and for PAD patients with reduced kidney function or diabetes, the ICER for older CAD patients was €63,745. [Extracted from the article]
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- 2019
- Full Text
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