4 results on '"Marie Guegan"'
Search Results
2. Risk factors of arterial thrombotic events after unprovoked venous thromboembolism, and after cancer associated venous thromboembolism: A prospective cohort study
- Author
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Steve Raoul, Noumegni, Romain, Didier, Vincent, Mansourati, Cécile, Tromeur, Emmanuelle, Le Moigne, Clément, Hoffmann, Bahaa, Nasr, Jean-Christophe, Gentric, Marie, Guegan, Elise, Poulhazan, Karine, Lacut, Luc, Bressollette, Raphael, Le Mao, and Francis, Couturaud
- Subjects
Cohort Studies ,Recurrence ,Risk Factors ,Neoplasms ,Anticoagulants ,Humans ,Thrombosis ,Prospective Studies ,Venous Thromboembolism ,Hematology ,Atherosclerosis ,Aged - Abstract
The increased risk of arterial thrombotic (ATE) after VTE, particularly when they are unprovoked or cancer-associated has been established. However, the risk factors of ATE after these VTE remain unclear.Using cause-specific hazard regression models, we determined risk factors of ATE (myocardial infarction, ischemic stroke, acute limb ischemia, digestive tract ischemia, or renal ischemia) in 2242 patients with unprovoked VTE and in 914 patients with cancer-associated VTE from a multi-center prospective cohort.Of patients with unprovoked-VTE, 174 developed ATE (7.8%, incidence: 1.26 per 100 patient-years) during follow-up (median: 68 months). Among patients with cancer-associated VTE, 57 developed ATE (6.2%, incidence: 1.98 per 100 patient-years) during follow-up (median: 30 months). After multivariable analysis, the identified risk factors of ATE in patients with unprovoked-VTE were age 65 years (vs.50 years, HR 2.59, 95% CI: 1.56-4.29), past history of symptomatic atherosclerosis (HR 2.11, 95% CI: 1.40-3.19), and treatment with low molecule weight heparin (vs. vitamin K antagonists, HR: 2.26, 95% CI: 1.13-4.52). In patients with cancer-associated VTE, the identified risk factors of ATE were: past history of symptomatic atherosclerosis (HR: 3.13, 95% CI: 1.72-5.67), and ongoing anticoagulation at the diagnosis of VTE (HR: 2.77, 95% CI: 1.07-7.22).The risk of ATE after unprovoked VTE and after cancer-associated VTE, is determined by some classic cardiovascular risk factors and appears to be influenced by anticoagulant treatment introduced for VTE, as well as the presence or absence of ongoing anticoagulation at the diagnosis of VTE.
- Published
- 2022
3. Risk factors for recurrence during a pregnancy following a first venous thromboembolism: A French observational study
- Author
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Claire de Moreuil, Cécile Tromeur, Aurore Daoudal, Christophe Trémouilhac, Philippe Merviel, François Anouilh, Raphaël Le Mao, Clément Hoffman, Marie Guegan, Elise Poulhazan, Lénaïck Gourhant, Catherine Lemarié, Francis Couturaud, and Emmanuelle Le Moigne
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Male ,Pregnancy ,Recurrence ,Risk Factors ,Anticoagulants ,Humans ,Female ,Obesity ,Prospective Studies ,Venous Thromboembolism ,Hematology - Abstract
Women with a previous venous thromboembolism (VTE) are at risk of recurrence during pregnancy.We aimed to assess the incidence rate of recurrent VTE during pregnancy, according to the period of pregnancy, and the clinical parameters associated with recurrence, in a prospective cohort of women of childbearing age after a first VTE.A total of 189 women aged 15-49 years with a first documented VTE were followed until a subsequent pregnancy of at least 20 weeks' gestation between 2000 and 2020. VTE recurrences during pregnancy were recorded, as were potential clinical risk factors for recurrence.Recurrent VTE occurred in six women during antepartum: five during the first trimester (incidence rate 106.4 per 1000 women-years) (95% confidence interval [CI] 46.3-226.0); none during the second trimester; and one during the third trimester (incidence rate 27.0 per 1000 women-years [95% CI 4.8-138.2]). During postpartum, recurrences occurred in 11 women (incidence rate 212.8 per 1000 women-years [95% CI 119.9-349.1]). These 17 recurrent VTEs presented as pulmonary embolism ± deep vein thrombosis (DVT) in five patients and isolated DVT in 12. Failure of thromboprophylaxis occurred in two cases (33.3%) antepartum and in 10 cases (90.9%) postpartum. In multivariable analysis, only obesity (defined on prepregnancy body mass index) was associated with recurrent VTE (odds ratio 3.34 [95% CI 1.11-10.05, p = .03]).This study confirms a high risk of recurrent VTE postpartum, despite thromboprophylaxis, in women with a previous VTE. Only obesity was associated with VTE recurrence during pregnancy, suggesting that low-dose anticoagulation might not be appropriate in obese pregnant women.
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- 2022
4. Long-term recurrence risk after a first venous thromboembolism in men and women under 50 years old: A French prospective cohort
- Author
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Xavier Savary, Elise Poulhazan, Brigitte Pan-Petesch, Clément Hoffmann, Marie Guegan, Karine Lacut, Emmanuelle Le Moigne, Raphael Le Mao, Michel Nonent, Pierre-Yves Salaun, Marc Danguy des Déserts, Christophe Leroyer, Cécile Tromeur, Claire de Moreuil, and Francis Couturaud
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Male ,Pediatrics ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Annual incidence ,Recurrence risk ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Recurrence ,Risk Factors ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Family history ,Prospective cohort study ,business.industry ,Anticoagulants ,Venous Thromboembolism ,Middle Aged ,equipment and supplies ,Cohort ,Female ,business ,Venous thromboembolism ,Cohort study - Abstract
Data on long-term venous thromboembolism (VTE) recurrence risk according to gender are conflicting.To evaluate long-term VTE recurrence risk after a first VTE in men and women under 50 years old.Since May 2000, 875 consecutive patients (315 men, 560 women) with a first symptomatic VTE under 50 years old were enrolled in a French prospective multicentre cohort study and were followed up as long as possible. The primary outcome was symptomatic recurrent VTE during follow-up.At baseline, men were older and had more comorbidities than women. First VTE was mainly unprovoked in men (80.6%) and hormone-related in women (84.3%). During a median follow-up of 7.0 years (inter-quartile range, 5.0-11.0), recurrent VTE occurred in 97 men (30.8%) and in 72 women (12.9%) (annual incidence rates of recurrent VTE of 4.8% versus 1.8%-person-years, P0.001). However, there was no difference according to gender in subgroups of patients with a first unprovoked VTE (5.8% versus 3.8%-person-years, P = 0.09). In women, duration of hormonal treatment before first VTE did not influence recurrence risk. In multivariable analysis, unprovoked VTE and family history of VTE were independently associated with recurrence (hazard ratio of 2.50 (95% confidence interval, 1.61 to 3.85) and 1.52 (1.11 to 2.09) respectively).Number of women with unprovoked VTE was low.In patients with a first VTE under 50 years old, a first unprovoked episode and a family history of VTE, but not gender, were associated with a high risk of long-term recurrence.
- Published
- 2021
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