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5. The absolute risk of venous thrombosis after air travel: a cohort study of 8,755 employees of international organisations

Author

Kuipers, Saskia, Cannegieter, Suzanne C., Middeldorp, Saskia, Robyn, Luc, Buller, Harry R., and Rosendaal, Frits R.

Subjects
Air travel -- Canada, Air travel -- Health aspects, Aircraft industry workers -- Health aspects, Aircraft industry workers -- Research, Thrombophlebitis -- Risk factors, Thrombophlebitis -- Research
Abstract

ABSTRACT Background The risk of venous thrombosis is approximately 2- to 4-fold increased after air travel, but the absolute risk is unknown. The objective of this study was to assess [...]

Published
2007

9. Thrombo-Inflammation in Cardiovascular Disease : An Expert Consensus Document from the Third Maastricht Consensus Conference on Thrombosis

Author

d'Alessandro, Elisa, Becker, Christian, Bergmeier, Wolfgang, Bode, Christoph, Bourne, Joshua H., Brown, Helena, Buller, Harry R., ten Cate-Hoek, Arina J., ten Cate, Vincent, van Cauteren, Yvonne J. M., Cheung, Yam F. H., Cleuren, Audrey, Coenen, Danielle, Crijns, Harry J. G. M., de Simone, Ilaria, Dolleman, Sophie C., Klein, Christine Espinola, Fernandez, Delia I., Granneman, Lianne, van t Hof, Arnoud, Henke, Peter, Henskens, Yvonne M. C., Huang, Jingnan, Jennings, Lisa K., Jooss, Natalie, Karel, Mieke, van den Kerkhof, Danique, Klok, Frederik A., Kremers, Bram, Laemmle, Bernhard, Leader, Avi, Lundstrom, Annika, Mackman, Nigel, Mannucci, Pier M., Maqsood, Zahra, van der Meijden, Paola E. J., van Moorsel, Marc, Moran, Luis A., Morser, John, van Mourik, Manouk, Navarro, Stefano, Neagoe, Raluca A. I., Olie, Renske H., van Paridon, Pauline, Posma, Jens, Provenzale, Isabella, Reitsma, Pieter H., Scaf, Billy, Schurgers, Leon, Seelig, Jaap, Siegbahn, Agneta, Siegerink, Bob, Soehnlein, Oliver, Soriano, Eva Maria, Sowa, Marcin A., Spronk, Henri M. H., Storey, Robert F., Tantiwong, Chukiat, Veninga, Alicia, Wang, Xueqing, Watson, Steve P., Weitz, Jeff, Zeerleder, Sacha S., ten Cate, Hugo, Lina, Badimon, Christoph, Binder, Marc, Hoylaerts, Peter, Karlheinz, GregoryLip, Koenen Rory, Steffen, Massberg, Philipp, von Hundelshausen, Christian, Weber, Johann, Wojta, d'Alessandro, Elisa, Becker, Christian, Bergmeier, Wolfgang, Bode, Christoph, Bourne, Joshua H., Brown, Helena, Buller, Harry R., ten Cate-Hoek, Arina J., ten Cate, Vincent, van Cauteren, Yvonne J. M., Cheung, Yam F. H., Cleuren, Audrey, Coenen, Danielle, Crijns, Harry J. G. M., de Simone, Ilaria, Dolleman, Sophie C., Klein, Christine Espinola, Fernandez, Delia I., Granneman, Lianne, van t Hof, Arnoud, Henke, Peter, Henskens, Yvonne M. C., Huang, Jingnan, Jennings, Lisa K., Jooss, Natalie, Karel, Mieke, van den Kerkhof, Danique, Klok, Frederik A., Kremers, Bram, Laemmle, Bernhard, Leader, Avi, Lundstrom, Annika, Mackman, Nigel, Mannucci, Pier M., Maqsood, Zahra, van der Meijden, Paola E. J., van Moorsel, Marc, Moran, Luis A., Morser, John, van Mourik, Manouk, Navarro, Stefano, Neagoe, Raluca A. I., Olie, Renske H., van Paridon, Pauline, Posma, Jens, Provenzale, Isabella, Reitsma, Pieter H., Scaf, Billy, Schurgers, Leon, Seelig, Jaap, Siegbahn, Agneta, Siegerink, Bob, Soehnlein, Oliver, Soriano, Eva Maria, Sowa, Marcin A., Spronk, Henri M. H., Storey, Robert F., Tantiwong, Chukiat, Veninga, Alicia, Wang, Xueqing, Watson, Steve P., Weitz, Jeff, Zeerleder, Sacha S., ten Cate, Hugo, Lina, Badimon, Christoph, Binder, Marc, Hoylaerts, Peter, Karlheinz, GregoryLip, Koenen Rory, Steffen, Massberg, Philipp, von Hundelshausen, Christian, Weber, and Johann, Wojta

Abstract

Thrombo-inflammation describes the complex interplay between blood coagulation and inflammation that plays a critical role in cardiovascular diseases. The third Maastricht Consensus Conference on Thrombosis assembled basic, translational, and clinical scientists to discuss the origin and potential consequences of thrombo-inflammation in the etiology, diagnostics, and management of patients with cardiovascular disease, including myocardial infarction, stroke, and peripheral artery disease. This article presents a state-of-the-art reflection of expert opinions and consensus recommendations regarding the following topics: (1) challenges of the endothelial cell barrier; (2) circulating cells and thrombo-inflammation, focused on platelets, neutrophils, and neutrophil extracellular traps; (3) procoagulant mechanisms; (4) arterial vascular changes in atherogenesis; attenuating atherosclerosis and ischemia/reperfusion injury; (5) management of patients with arterial vascular disease; and (6) pathogenesis of venous thrombosis and late consequences of venous thromboembolism.

Published
2020
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10. The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis

Author

Mulder, Frits I. Candeloro, Matteo Kamphuisen, Pieter W. Di Nisio, Marcello Bossuyt, Patrick M. Guman, Noori Smit, Kirsten Buller, Harry R. van Es, Nick Abdel-Razeq, H. and Ades, S. Ayappan, S. R. Borchmann, S. Cella, C. A. and Fankhauser, C. D. Ferroni, P. Fuentes, H. E. Kruger, S. and Lim, S. H. Lubberts, S. Lustig, D. B. Mansfield, A. S. and Munoz Martin, A. J. Noble, S. Panizo, E. Papaxoinis, G. and Park, K. Patel, J. N. Posch, F. Ramos, J. D. Roselli, M. and Santi, R. Sohal, D. Srikanthan, A. Tafur, A. J. and Terbuch, A. Thomas, M. Vathiotis, O. Wang, R. Zahir, M. N. CAT-prediction Collaborators

Abstract

We aimed to evaluate the performance of the Khorana score in predicting venous thromboembolic events in ambulatory cancer patients. Embase and MEDLINE were searched from January 2008 to June 2018 for studies which evaluated the Khorana score. Two authors independently screened studies for eligibility, extracted data, and assessed risk of bias. Additional data on the 6-month incidence of venous thromboembolism were sought by contacting corresponding authors. The incidence in each Khorana score risk group was estimated with random effects meta-analysis. A total of 45 articles and eight abstracts were included, comprising 55 cohorts enrolling 34,555 ambulatory cancer patients. For 27,849 patients (81%), 6-month follow-up data were obtained. Overall, 19% of patients had a Khorana score of 0 points, 64% a score of 1 or 2 points, and 17% a score of 3 or more points. The incidence of venous thromboembolism in the first six months was 5.0% (95% CI: 3.9-6.5) in patients with a low-risk Khorana score (0 points), 6.6% (95% CI: 5.6-7.7) in those with an intermediate-risk Khorana score (1 or 2 points), and 11.0% (95% CI: 8.8-13.8) in those with a high-risk Khorana score (3 points or higher). Of the patients with venous thromboembolism in the first six months, 23.4% (95% CI: 18.4-29.4) had been classified as high risk according to the Khorana score. In conclusion, the Khorana score can be used to select ambulatory cancer patients at high risk of venous thromboembolism for thromboprophylaxis; however, most events occur outside this high-risk group.

Published
2019

12. The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis

Author

Mulder, Frits I., Candeloro, Matteo, Kamphuisen, Pieter W., Di Nisio, Marcello, Bossuyt, Patrick M., Guman, Noori, Smit, Kirsten, Buller, Harry R., van Es, Nick, Abdel-Razeq, H., Ades, S., Ayappan, S. R., Borchmann, S., Cella, C. A., Fankhauser, C. D., Ferroni, P., Fuentes, H. E., Kruger, S., Lim, S. H., Lubberts, S., Lustig, D. B., Mansfield, A. S., Munoz Martin, A. J., Noble, S., Panizo, E., Papaxoinis, G., Park, K., Patel, J. N., Posch, F., Ramos, J. D., Roselli, M., Santi, R., Sohal, D., Srikanthan, A., Tafur, A. J., Terbuch, A., Thomas, M., Vathiotis, O., Wang, R., Zahir, M. N., Mulder, Frits I., Candeloro, Matteo, Kamphuisen, Pieter W., Di Nisio, Marcello, Bossuyt, Patrick M., Guman, Noori, Smit, Kirsten, Buller, Harry R., van Es, Nick, Abdel-Razeq, H., Ades, S., Ayappan, S. R., Borchmann, S., Cella, C. A., Fankhauser, C. D., Ferroni, P., Fuentes, H. E., Kruger, S., Lim, S. H., Lubberts, S., Lustig, D. B., Mansfield, A. S., Munoz Martin, A. J., Noble, S., Panizo, E., Papaxoinis, G., Park, K., Patel, J. N., Posch, F., Ramos, J. D., Roselli, M., Santi, R., Sohal, D., Srikanthan, A., Tafur, A. J., Terbuch, A., Thomas, M., Vathiotis, O., Wang, R., and Zahir, M. N.

Abstract

We aimed to evaluate the performance of the Khorana score in predicting venous thromboembolic events in ambulatory cancer patients. Embase and MEDLINE were searched from January 2008 to June 2018 for studies which evaluated the Khorana score. Two authors independently screened studies for eligibility, extracted data, and assessed risk of bias. Additional data on the 6-month incidence of venous thromboembolism were sought by contacting corresponding authors. The incidence in each Khorana score risk group was estimated with random effects meta-analysis. A total of 45 articles and eight abstracts were included, comprising 55 cohorts enrolling 34,555 ambulatory cancer patients. For 27,849 patients (81%), 6-month follow-up data were obtained. Overall, 19% of patients had a Khorana score of 0 points, 64% a score of 1 or 2 points, and 17% a score of 3 or more points. The incidence of venous thromboembolism in the first six months was 5.0% (95% CI: 3.9-6.5) in patients with a low-risk Khorana score (0 points), 6.6% (95% CI: 5.6-7.7) in those with an intermediate-risk Khorana score (1 or 2 points), and 11.0% (95% CI: 8.8-13.8) in those with a high-risk Khorana score (3 points or higher). Of the patients with venous thromboembolism in the first six months, 23.4% (95% CI: 18.4-29.4) had been classified as high risk according to the Khorana score. In conclusion, the Khorana score can be used to select ambulatory cancer patients at high risk of venous thromboembolism for thromboprophylaxis; however, most events occur outside this high-risk group.

Published
2019

14. Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients

Author

Engelbrecht, J., Finfer, S., Van Dyk, C., Cohen, Alexander, Grandes, J., Cepeda, J. M., NAZLIEL, BİJEN, Cohen, Alexander T., Efrati, S., Zakai, N., Yousef, K., Wichman, T., Whitman, B., Welker, J., Welch, M., Warner, A., Updegrove, J., Tuck, M., Stoltz, S., Sokol, S., Sharma, S., Shammas, N., Saba, F., Rodriguez, W., Rees, C., Rastogi, P., Rajan, R., Quintana, O., Pullman, J., Pratt, R., Pineda, L., Pearl, R., Parthiban, K., Overcash, J., Ortel, T., Ohaju, V., Nadar, V., Mittal, M., Milling, T., McLaren, G., Margolis, B., Mahal, S., Macchiavelli, A., Lopez, J., Lerner, R., Kung, M., Kouras, F., Kazimir, M., Kao, C-K., Kabler, H., Ioachimescu, O., Hazelrigg, M., Hamad, A., Haidar, A., Hahn, B., Goytia-Leos, D., Gaggin, H., Fulmer, J., Fraiz, J., Fermann, G., Farley, B., Doshi, A., Dhingra, R., Cornell, J., Concha, M., Clark, C., Chang, H., Carman, T., Bidair, M., Bercz, P., Bastani, A., Barney, J., Baker, S., Anderson, C., Amin, M., Almasri, E., Natarajan, I., McCollum, C., MacCallum, P., Davis, M., Body, R., Yagensky, A., Voronkov, L., Vishnivestsky, I., Vakaliuk, I., Ursol, G., Tseluyko, V., Svyshchenko, Y., Svyridova, I., Ryabichenko, T., Rudenko, L., Alekniene, B., Reshotko, D., Perepeliuk, M., Parkhomenko, O., Nikonov, V., Maslovaskyi, V., Malynovsky, Y., Legkonogov, O., Kyrychenko, I., Krakhmalova, O., Koshlia, V., Kopytsya, M., Karpenko, O., Gryb, V., Goncharova, Y., Goloborodko, B., Goloborodko, A., Godlevska, O., Burmak, I., Brozhyk, J., Batushkin, V., Abrahamovych, O., Tuncay, E., Topcuoglu, M., Tigen, K., Okumus, G., Kutluk, H., Kirma, C., Kilichesmez, K., Guneri, S., Akgul, O., Villalta, J., Vargas Nunez, J. A., Trujillo, J., Riera, A., Richart, C., Mellibovsky, L., Jimenez, D., Gonzales-Porras, J. R., Gomez Cerezo, J., Ferrer, R., Diaz Santos, E., Cereto, F., Castro Guardiola, A., Bisbe, J., Barbagelata Lopez, C., Alvarez Sala, L. A., Mitha, I., Breedt, J., Basson, M., Adler, D., Spisakova, M., Prokop, D., Payer, J., Krastev, G., Kokles, M., Hrubon, A., Herman, O., Dvorak, M., Cervenakova, A., Bodikova, S., Miloradovic, V., Kovacevic-Kuzmanovic, A., Ilic, S., Celic, V., Apostolovic, S., Vishnevskiy, A., Vishneva, E., Solovyov, O., Simanenkov, V., Shvarts, Y., Shpagina, L., Shapovalova, Y., Sergeeva, E., Reshetko, O., Privalova, E., Popov, D., Nilk, R., Nikolaev, K., Mordovin, V., Maslova, N., Martynenko, V., Martynenko, T., Malygin, A., Kostenko, V., Kosmacheva, E., Kobalava, Z., Klein, G., Khachatryan, N., Goloshchekin, B., Ershova, O., Dovgalevskiy, Y., Chefranova, Z., Boldueva, S., Bogdanov, E., Belskaya, G., Barbarash, O., Averkov, O., Arkhipov, M., Apartsin, K., Andreev, D., Abashev, A., Vida-Simiti, L., Stanciulescu, G., Stamate, S., Harrington, Robert A., Goldhaber, Samuel Z., Hull, Russell D., Popescu, M., Wiens, Brian L., Gold, Alex, Hernandez, Adrian F., Gibson, C. Michael, Harrington, Robert, Hull, Russell, Goldhaber, Samuel, Hernandez, Adrian, Ceresetto, Jose Manuel, Colquhoun, David, Pilger, Ernst, Polonetsky, Leonid, Podoleanu, C., Musetescu, R., Marin, I., Bojinca, M., Motte, Serge, Saraiva, Jose Francisco, Balogh, Z. E., Wrzesinski, K., Waldemar, K., Walasek, L., Raev, Dimitar, Mincheva, Valentina, Kahn, Susan, Sulik, P., Canon, Claudia Olivares, Malojcic, Branko, Mayer, Otto, Husted, Steen, Marandi, Toomas, Lassila, Riitta, Mottier, Dominique, Shaburishvili, Tamaz, Bauersachs, Rupert, Zeymer, Uwe, Hajko, Erik, Sobkowicz, B., Zeltser, David, Ageno, Walter, Krievins, Dainis, Bagdonas, Alfredas, Osores, Juan Lema, Tomkowski, Witold, Mot, Stefan, Panchenko, Elizaveta, Tan, Ru San, Gaspar, Ludovit, Jacobson, Barry, Monreal, Manuel, Ongen, Gul, Parkhomenko, Alexander, Uprichard, James, Pulkowski, G., Mirek-Bryniarska, E., Kucharski, L., Jastrzebski, D., Yusen, Roger, Grzelakowski, P., Merli, Geno, Gruenpeter, P., Gorecka, D., Gniot, J., Gaciong, Z., Fryze, W., Peacock, Frank, Schellong, Sebastian, Januzzi, James, Piovella, Franco, Cochet, Madeleine, Michalak, Nathan, Stepanchak, Maria, Spielman, Kathryn, Neal, Brandon, Florea, Ana, Chi, Gerald, Szlosek, Donald, Jain, Purva, Popma, Christopher, Korjian, Serge, Daaboul, Yazan, Halaby, Rim, Yanez, L. Toche, Lemor, Alejandro, Zacarkim, Marcelo, Romero, Gonzalo, Hernandez Elenes, Jesus Rosario, Alvarado, Alonso, Susheela, Ammu, Leitao, Meghan, Salas, M., Bandman, Olga, Horna, M., Strumph, Peter, Vinh, Nancy, Visona, A., Kostadinova, M., Vance, Annemarie, Moia, M., Wiens, Brian, Orlandini, F., Parisi, R., Pontaga, N., Smoak, Carey, Storgaard, M., Molteni, M., Castelino, Rennie, Goodman, Shelly, Stukena, I., Leeds, Janet, al-Khalidi, Hussein, Milanova, M., Karlo, L. Farjardo, Leimberger, Jeffrey, Phillips, Thomas, Rizos, T., Pencheva, G., Pomero, F., Francis, Charles, Novo, S., Pereyra, R. Cotrina, Tiefenbacher, C., Buller, Harry, Roberts, Robin, Prins, Martin, Weimar, C., Tuxen, C., Urhammer, S., Lember, M., Runev, N., Uuetoa, T., Spyropoulos, Alex, Carrier, Marc, Alkonyi, B., Lopes, Renato D., Horacek, T., Airaksinen, J., Honkaniemi, J., Pottier, P., Falukozy, J., Kaaja, R., Stoeva, N., Saarinen, J., Stoyanov, M., Pizzini, A., Devor, Adam, Tatlisumak, T., Kolls, Bradley, Dedrick, Joseph, Todd, Jamie, Jones, William Schuyler, Vikman, S., Agraou, B., Futo, L., Castillo Leon, R., Eapen, Zubin, Katona, A., Proust, A., Quere, I., Kirschner, R., Syulemzova, S., Valavicius, A., Todorov, G., Tokmakova, M., Dhar, A., Klimpe, S., Ahmad, Tariq, Brenna, J. Matthew, Douketis, J., Le Gal, G., Pearce, M., Susinskiene, D., Brito, Flavio, Provencher, S., Rozitis, V., Roy, P-M., Kroning, R., Gulack, Brian, Schmidt, J., Meza, James, Parikh, Kishan, Cooper, Lauren, Poskiene, R., Aquilanti, S., Lapp, H., Kristof, P., Lakatos, F., Laszlo, Z., Belhassane, A., Petrauskiene, R., Pagidipati, Neha, Simoneau, G., Verreault, S., Guimaraes, Patricia, Brisot, D., Perkins, Lynn M., De Geeter, G., Debourdeau, P., Alarcon, M. Arias, Lupkovics, G., Norviliene, R., Wilson, Matthew, Merkely, B., Lazcano, M. Opazo, Collier, Jeannie, Andras, C. Nagy, Cardenas, S. Potthoff, Butkovic-Soldo, S., Norvaisiene, R., Decoulx, E., Hayden, Nikieia, El Kouri, D., Car, S., Nemeth, L., Leizorovicz, Alain, Ciglenecki, N., Naudziunas, A., Datikashvili-David, I., Francetic, I., Jakopovic, M., Becker, Francois, Jennings, Lisa, Khabeishvili, G., Bello, F., Ferrari, A. E., Jure, H., Macin, S., Griskeviciene, V., Kalinic-Grgorinic, H., Falvo, N., Khintibidze, I., Grange, C., Kobulia, B., Knezevic, A., Megreladze, I., Marusic, S., Papp, A., Pagava, Z., Lawall, H., Oliva, M., Paposhvili, K., Parody, M., Amann, B., Soltesz, P., Sudar, Z., Butkiene, Z., Szabo, G., Vagic, J. Sikic, Szegedi, N., Poy, C., Timar, G., Skerk, V., Cermak, O., Valco, J., Baker, R., Coughlin, P., Vertes, A., Rubinfeld, A., Elias, M., Berrouschot, J., Gafter, A., Hayek, T., Chlumsky, J., Lacroix, P., Messas, E., Chochola, J., Cizek, V., Basijokiene, V., Hussein, O., Dunaj, M., Dusek, J., Huber, K., Lishner, M., Lugassy, G., Cerveri, I., D'Angelo, A., De Pellegrin, A., Francek, L., Havelka, J., Konig, J., Beyer-Westendorf, J., Herold, M., Holaj, R., Imberti, D., Landolfi, R., Blessing, E., Mathies, R., Schoenerr, H., Adzerikho, I., Koryk, V., Licka, M., Martinova, V., Horny, I., Mikhailova, E., Mitkovskaya, N., Pimanov, S., Polonetsy, L., Soroka, N., Blockmans, D., Delforge, M., Dive, A., Lienart, F., Bizzacchi, J. Annichino, Fiss, E., Mismetti, P., Freire, A., Hubac, J., Jajtner, P., Manenti, E., Ramacciotti, E., Lembo, G., Raymuno, S., Rocha, A., Kolman, P., Lang, P., Bott, M., Dengler, T., Mikulova, J., Dimov, B., Podpera, I., Reiterer, P., Dziewas, R., Montaclair, K., Genth-Zotz, S., Hamann, F., Paleiron, N., Spacek, R., Payot, L., Vejvoda, J., Vyhnanek, M., Christensen, H., Salvi, A., Lodigiani, C., Pernod, G., Grigorov, M., Lassen, M., Mumoli, N., Kalpachki, R., Kamenova, Z., Schenone, A., Guy's and St Thomas' Hospital [London], Stanford Medicine, Stanford University, Brigham and Women's Hospital [Boston], Thrombosis Research Unit, University of Calgary, Portola Pharmaceuticals (Portola), PORTOLA PHARMACEUTICALS, Division of Cardiology, Duke University Medical Center, Duke Clinical Research Institute (DCRI - DURHAM), Duke University [Durham], Beth Israel Deaconess Medical Center [Boston, USA], Harvard Medical School [Boston] (HMS), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)

Subjects
Male, Pyridines, Medizin, 030204 cardiovascular system & hematology, law.invention, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, Risk Factors, law, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Ultrasonography, Venous Thrombosis, Factors de risc en les malalties, Medicine (all), Acute Disease, Adult, Aged, Benzamides, Double-Blind Method, Drug Administration Schedule, Factor Xa Inhibitors, Female, Fibrin Fibrinogen Degradation Products, Hemorrhage, Hospitalization, Humans, Middle Aged, Pulmonary Embolism, Venous Thromboembolism, General Medicine, 3. Good health, Pulmonary embolism, Venous thrombosis, Cohort, medicine.medical_specialty, Patients, Risk factors in diseases, Placebo, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Thromboembolism, medicine, Pacients, Betrixaban, Thromboprophylaxis, Acutely Ill Medical Patients, Tromboembolisme, business.industry, Settore MED/09 - MEDICINA INTERNA, ta3121, Population cohort, medicine.disease, Surgery, chemistry, Once daily, business
Abstract

Background\ud Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown.\ud \ud Methods\ud Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding.\ud \ud Results\ud A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55).\ud \ud Conclusions\ud Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218. opens in new tab.)

Published
2016
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16. Managing reversal of direct oral anticoagulants in emergency situations Anticoagulation Education Task Force White Paper

Author

Ageno, Walter, Buller, Harry R., Falanga, Anna, Hacke, Werner, Hendriks, Jeroen, Lobban, Trudie, Merino, Jose, Milojevic, Ivan S., Moya, Francisco, Bart van der Worp, H., Randall, Gary, Tsioufis, Konstantinos, Verhamme, Peter, John Camm, A., Ageno, Walter, Buller, Harry R., Falanga, Anna, Hacke, Werner, Hendriks, Jeroen, Lobban, Trudie, Merino, Jose, Milojevic, Ivan S., Moya, Francisco, Bart van der Worp, H., Randall, Gary, Tsioufis, Konstantinos, Verhamme, Peter, and John Camm, A.

Abstract

Anticoagulation is the cornerstone of prevention and treatment of venous thromboembolism (VTE) and stroke prevention in patients with atrial fibrillation (AF). However, the mechanisms by which anticoagulants confer therapeutic benefit also increase the risk of bleeding. As such, reversal strategies are critical. Until recently, the direct oral anticoagulants (DOACs) dabigatran, rivaroxaban, apixaban, and edoxaban lacked a specific reversal agent. This report is based on findings from the Anticoagulation Education Task Force, which brought together patient groups and professionals representing different medical specialties with an interest in patient safety and expertise in AF, VTE, stroke, anticoagulation, and reversal agents, to discuss the current status of anticoagulation reversal and fundamental changes in management of bleeding associated with DOACs occasioned by the approval of idarucizumab, a specific reversal agent for dabigatran, as well as recent clinical data on specific reversal agents for factor Xa inhibitors. Recommendations are given for when there is a definite need for a reversal agent (e.g. in cases of life-threatening bleeding, bleeding into a closed space or organ, persistent bleeding despite local haemostatic measures, and need for urgent interventions and/or interventions that carry a high risk for bleeding), when reversal agents may be helpful, and when a reversal agent is generally not needed. Key stakeholders who require 24-7/around-the-clock access to these agents vary among hospitals; however, from a practical perspective the emergency department is recommended as an appropriate location for these agents. Clearly, the advent of new agents requires standardised protocols for treating bleeding on an institutional level., Funding Agencies|Boehringer Ingelheim

Published
2016
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17. RECURRENT VENOUS THROMBOEMBOLISM IN PULMONARY EMBOLISM PATIENTS WITH RIGHT VENTRICULAR DYSFUNCTION IN THE HOKUSAI-VTE STUDY

Author

Brekelmans, Marjolein, primary, Ageno, Walter, additional, Beenen, Ludo F., additional, Brenner, Benjamin, additional, Buller, Harry, additional, Chen, Cathy, additional, Cohen, Alexander (Ander), additional, Grosso, Michael, additional, Meyer, Guy, additional, Raskob, Gary, additional, Segers, Annelise, additional, Vanassche, Thomas, additional, Verhamme, Peter, additional, Wells, Philip S., additional, Zhang, George, additional, and Weitz, Jeffrey, additional

Published
2016
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18. Use of heparins in patients with cancer: individual participant data meta-analysis of randomised trials study protocol

Author

Schünemann, Holger J, primary, Ventresca, Matthew, additional, Crowther, Mark, additional, Briel, Matthias, additional, Zhou, Qi, additional, Garcia, David, additional, Lyman, Gary, additional, Noble, Simon, additional, Macbeth, Fergus, additional, Griffiths, Gareth, additional, DiNisio, Marcello, additional, Iorio, Alfonso, additional, Beyene, Joseph, additional, Mbuagbaw, Lawrance, additional, Neumann, Ignacio, additional, Van Es, Nick, additional, Brouwers, Melissa, additional, Brozek, Jan, additional, Guyatt, Gordon, additional, Levine, Mark, additional, Moll, Stephan, additional, Santesso, Nancy, additional, Streiff, Michael, additional, Baldeh, Tejan, additional, Florez, Ivan, additional, Gurunlu Alma, Ozlem, additional, Solh, Ziad, additional, Ageno, Walter, additional, Marcucci, Maura, additional, Bozas, George, additional, Zulian, Gilbert, additional, Maraveyas, Anthony, additional, Lebeau, Bernard, additional, Buller, Harry, additional, Evans, Jessica, additional, McBane, Robert, additional, Bleker, Suzanne, additional, Pelzer, Uwe, additional, and Akl, Elie A, additional

Published
2016
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19. International Clinical Practice Guidelines for the Treatment and Prophylaxis of Thrombosis Associated with Central Venous Catheters in Patients with Cancer

Author

Philippe, Debourdeau Dominique, Farge Marielle, Beckers and Baglin, Caroline Bauersachs, Rupert Brenner, Benjamin and Brillhante, Dialina Falanga, Anna Gerotziafas, Grigoris T. and Haim, Nissim Kakkar, Ajay Khorana, Alok A. Lecumberri, Ramon and Mandala, Mario Marty, Michel Monreal, Manuel Mousa, Shaker S. Noble, Simon Pabinger, Ingrid Prandoni, Paolo and Prins, Martin Qari, Mohammed H. Streiff, Michael B. Syrigos, Konstantin Buller, Harry Roger Bounameaux, Henri

Published
2012

20. Limitations of screening for occult cancer in patients with idiopathic venous thromboembolism

Author

Kleinjan, A., van Doormaal, F. F., Prins, M. H., Buller, Harry R., Otten, J. M. M. B., Other departments, Vascular Medicine, Amsterdam Cardiovascular Sciences, Epidemiologie, MUMC+: KIO Kemta (9), Promovendi CD, and RS: CAPHRI School for Public Health and Primary Care

Subjects
occult cancer, idiopathic venous thromboembolism, costs, Whole body CT screening
Abstract

Background: Idiopathic venous thrombosis (IVT) is associated with occult malignancy in 10% of patients. The Trousseau study investigated whether extensive screening using abdominal and chest computed tomography (CT) scans and mammography in women would decrease mortality, compared with limited screening. Here, the costs and test characteristics of these screening strategies are presented, including true-and false-positive findings, sensitivity and specificity. Methods: All investigations performed because of a suspicion of malignancy in the limited or extensive screening groups were collected. Costs were calculated using Dutch healthcare tariffs. Results: A total of 342 and 288 patients with IVT were included in the extensive and the limited screening group, respectively. The prevalences of malignancy and mortality were comparable between these two groups, as were the abnormal findings during routine screening. In 30% of the extensively screened patients, the CT scans or mammography showed abnormalities necessitating further diagnostic work-up; this yielded six malignancies and resulted in a positive predictive value of 6.6%, sensitivity of 33% and specificity of 70%. Mean costs per patient were (sic) 165.17 for the routine and (sic) 530.92 for the extensive screening. Conclusion: Screening using CT scans and mammography results in extra costs due to the high percentage of false-positive findings for which a further diagnostic work-up is indicated

Published
2012

21. Risk factors of arterial cardiovascular complications in patients with prior venous thromboembolism

Author

Roshani, S., Lijfering, W. M., Coppens, Magali, Hamulyak, K., Prins, M. H., Buller, Harry R., Middeldorp, S., Vascular Medicine, Amsterdam Cardiovascular Sciences, Interne Geneeskunde, Epidemiologie, MUMC+: KIO Kemta (9), Biochemie, RS: CARIM School for Cardiovascular Diseases, and RS: CAPHRI School for Public Health and Primary Care

Subjects
EVENTS, THROMBOSIS, Cardiovascular diseases, PULMONARY-EMBOLISM, venous thromboembolism, risk factors, COHORT, SUBCLINICAL ATHEROSCLEROSIS, DISEASE, thrombophilia
Abstract

Background. The effect of cardiovascular risk factors (CVRs) and thrombophilic defects on the risk of arterial cardiovascular complications in patients with prior venous thromboembolism (VTE) is unclear. Objective. We investigated whether the risk of arterial cardiovascular complications is increased after VTE and whether CVRs and thrombophilic defects influence this risk. Methods. Subjects were selected from three family cohorts of probands with VIE or arterial cardiovascular complication before the age of 50 and thrombophilic defects (i.e. hyperhomocysteinaemia, prothrombin G20210A or elevated FVIII). For this analysis, probands with arterial cardiovascular complications before inclusion and their relatives as well as relatives without the studied thrombophilic defects were excluded. We calculated the incidence of arterial cardiovascular complications (e.g. myocardial infarction, ischaemic stroke, transient ischaemic attack or peripheral arterial disease) in subjects with and without VIE and adjusted the relative risk for at least one CVR, two or more thrombophilic defects and quintiles of a propensity score (considering risk factors conditional to VTE history). Results. 861 subjects were included, of whom 399 had experienced VIE before inclusion. Twelve arterial cardiovascular complications occurred in subjects with and nine in subjects without VIE history. Hence the annual incidence was 1.0 (95% CI 0.5 to 1.7) and 0.7 (0.3 to 1.2) in subjects with and without VIE (RR 1.5, 0.6 to 3.6). Adjusting for possible confounders did not change this relative risk. Conclusion. The mildly elevated risk of arterial cardiovascular complications in patients with prior VTE appears to be independent of cardiovascular risk factors and thrombophilic defects.

Published
2011

23. Time in Therapeutic Range (TTR) and Relative Efficacy and Safety of Treatment with Apixaban or Enoxaparin/Warfarin for Acute Symptomatic Venous Thromboembolism: An Analysis of the Amplify Trial Data

Author

Cohen, Alexander, primary, Gallus, Alexander S., additional, Agnelli, Giancarlo, additional, Buller, Harry R, additional, Pak, Raphael, additional, Porcari, Anthony R., additional, Raskob, Gary E., additional, Weitz, Jeffrey I., additional, and Yamabe, Takaharu, additional

Published
2014
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27. Reply

Author

Apostolakis, Stavros, primary, Lane, Deirdre A., additional, Guo, Yutao, additional, Buller, Harry, additional, and Lip, Gregory Y.H., additional

Published
2013
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29. International Good Clinical Practices Guidelines (GCPG) for Antithrombotics in CANCER Patients

Author

Dominique, Farge, primary, Philippe, Debourdeau, additional, Marielle, Beckers, additional, Baglin, Caroline, additional, Bauersachs, Rupert, additional, Brenner, Benjamin, additional, Brilhante, Dialina, additional, Falanga, Anna, additional, Gerotziafas, Grigoris T, additional, Haim, Nissim, additional, Kakkar, Ajay, additional, Khorana, Alok A., additional, Lecumberri, Ramon, additional, Mandala, Mario, additional, Marthy, Michel, additional, Monreal, Manuel, additional, Mousa, Shaker S, additional, Noble, Simon, additional, Pabinger, Ingrid, additional, Prandoni, Paolo, additional, Prins, Martin, additional, Qari, Mohammed H., additional, Streiff, Michael B., additional, Syrigos, Konstantin, additional, Bounameaux, Henri, additional, and Buller, Harry Roger, additional

Published
2012
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31. International Clinical Practice Guidelines for the Treatment and Prophylaxis of Thrombosis Associated with Central Venous Catheters in Patients with Cancer

Author

Philippe, Debourdeau, primary, Dominique, Farge, additional, Marielle, Beckers, additional, Baglin, Caroline, additional, Bauersachs, Rupert, additional, Brenner, Benjamin, additional, Brilhante, Dialina, additional, Falanga, Anna, additional, Gerotziafas, Grigoris T, additional, Haim, Nissim, additional, Kakkar, Ajay, additional, Khorana, Alok A., additional, Lecumberri, Ramon, additional, Mandala, Mario, additional, Marty, Michel, additional, Monreal, Manuel, additional, Mousa, Shaker S, additional, Noble, Simon, additional, Pabinger, Ingrid, additional, Prandoni, Paolo, additional, Prins, Martin, additional, Qari, Mohammed H., additional, Streiff, Michael B., additional, Syrigos, Konstantin, additional, Buller, Harry Roger, additional, and Bounameaux, Henri, additional

Published
2012
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34. Paediatric anticoagulation guidelines

Author

Schapkaitz, Elise, primary, Sherman, Gayle Gillian, additional, Jacobson, Barry Frank, additional, Haas, Sylvia, additional, Buller, Harry R, additional, Davies, Victor, additional, Diar, Hitesh, additional, Peters, Marjolein, additional, Shuttleworth, Margaret, additional, and Velaphi, Sithembiso, additional

Published
2012
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39. Aspirin and Aspirin Combined with Low-Molecular-Weight Heparin in Women with Unexplained Recurrent Miscarriage: a Randomized Controlled Multicenter Trial (ALIFE Study).

Author

Kaandorp, Stef P., primary, Goddijn, Mariëtte, additional, Post, Joris A.M. van der, additional, Hutten, Barbara A., additional, Verhoeve, Harold R., additional, Hamulyak, Karly, additional, Mol, Ben-Willem, additional, Folkeringa, Nienke, additional, Nahuis, Marleen, additional, Papatsonis, Dimitri, additional, Buller, Harry R., additional, Veen, Fulco van der, additional, and Middeldorp, Saskia, additional

Published
2009
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40. High Levels of Protein C Are Determinated by PROCR H3 in a Dutch Family.

Author

Pintao, Maria Carolina, primary, Roshani, Sara, additional, de Visser, Marieke C.H., additional, Tieken, Cris, additional, Tanck, Michael W.T., additional, Buller, Harry Roger, additional, Wichers, Iris M, additional, Meijers, Joost C.M., additional, Middeldorp, Saskia, additional, and Reitsma, Pieter H., additional

Published
2009
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47. A Reduced Capacity To Generate Activated Protein C and the Role of PAI-1 Deficiency on Coagulation Activation and Fibrin Formation during Murine Influenza Pneumonia.

Author

Keller, Tymen, primary, van Wissen, Matthijs, additional, van der Sluijs, Koen, additional, van Gorp, Eric, additional, Meijers, Joost, additional, van der Poll, Tom, additional, Buller, Harry, additional, Brandjes, Dees, additional, Levi, Marcel, additional, and Gerdes, Victor, additional

Published
2005
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