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1. Edoxaban for the Long‐Term Therapy of Venous Thromboembolism: Should the Criteria for Dose Reduction be Revised?

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

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

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

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

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

4. Predictors of active cancer thromboembolic outcomes

Author: Tafur, A. J., Caprini, J. A., Cote, L., Trujillo-Santos, J., del Toro, J., Garcia-Bragado, F., Tolosa, C., Barillari, G., Visona, A., Monreal, M., Adarraga, M. D., Aibar, M. A., Alfonso, M., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barrn-Andres, B., Bascunana, J., Blanco-Molina, A., Canas, I., Chic, N., del Pozo, R., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Falga, C., Fernandez-Aracil, C., Fernandez-Capitan, C., Fidalgo, M. A., Font, C., Font, L., Gallego, P., Garcia, I., Garcia, M. A., Garcia-Rodenas, M., Gavin, O., Gomez, C., Gomez, V., Gonzalez, J., Grau, E., Grimon, A., Guijarro, R., Guirado, L., Gutierrez, J., Hernandez-Comes, G., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, J., Joya, M. D., Llamas, P., Lobo, J. L., Lopez, P., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Lumbierres, M., Marchena, P. J., Martin-Martos, F., Mellado, M., Nieto, J. A., Nieto, S., Nunez, A., Nunez, M. J., Otalora, S., Otero, R., Ovejero, A., Pedrajas, J. M., Perez, G., Perez-Ductor, C., Peris, M. L., Pons, I., Porras, J. A., Reig, O., Riera-Mestre, A., Riesco, D., Rivas, A., Rodriguez, M., Rodriguez-Davila, M. A., Rosa, V., Ruiz-Artacho, P., Ruiz-Gimenez, N., Sahuquillo, J. C., Sala-Sainz, M. C., Samperiz, A., Sanchez-Martinez, R., Sanz, O., Soler, S., Sopena, B., Surinach, J. M., Torres, M. I., Uresandi, F., Usandizaga, E., Valero, B., Valle, R., Vela, J., Velez-Mendizabal, E., Vidal, G., Vila, M., Villalobos, A., Xifre, B., Vanassche, T., Verhamme, P., Yoo, H. H. B., Wells, P., Hirmerova, J., Maly, R., Salgado, E., Bertoletti, L., Bura-Riviere, A., Falvo, N., Farge-Bancel, D., Hij, A., Mahe, I., Moustafa, F., Braester, A., Brenner, B., Tzoran, I., Antonucci, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Candeloro, G., Cattabiani, C., Ciammaichella, M., Dentali, F., Di Micco, P., Duce, R., Giorgi-Pierfranceschi, M., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Pace, F., Parisi, R., Pellegrinet, M., Pesavento, R., Pinelli, M., Poggio, R., Prandoni, P., Quintavalla, R., Rocci, A., Tiraferri, E., Tonello, D., Tufano, A., Gibietis, V., Skride, A., Vitola, B., Bosevski, M., Zdraveska, M., Bounameaux, H., Mazzolai, L., Tafur, A. J., Caprini, J. A., Cote, L., Trujillo-Santos, J., del Toro, J., Garcia-Bragado, F., Tolosa, C., Barillari, G., Visona, A., Monreal, M., Adarraga, M. D., Aibar, M. A., Alfonso, M., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barrn-Andres, B., Bascunana, J., Blanco-Molina, A., Canas, I., Chic, N., del Pozo, R., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Falga, C., Fernandez-Aracil, C., Fernandez-Capitan, C., Fidalgo, M. A., Font, C., Font, L., Gallego, P., Garcia, I., Garcia, M. A., Garcia-Rodenas, M., Gavin, O., Gomez, C., Gomez, V., Gonzalez, J., Grau, E., Grimon, A., Guijarro, R., Guirado, L., Gutierrez, J., Hernandez-Comes, G., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, J., Joya, M. D., Llamas, P., Lobo, J. L., Lopez, P., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Lumbierres, M., Marchena, P. J., Martin-Martos, F., Mellado, M., Nieto, J. A., Nieto, S., Nunez, A., Nunez, M. J., Otalora, S., Otero, R., Ovejero, A., Pedrajas, J. M., Perez, G., Perez-Ductor, C., Peris, M. L., Pons, I., Porras, J. A., Reig, O., Riera-Mestre, A., Riesco, D., Rivas, A., Rodriguez, M., Rodriguez-Davila, M. A., Rosa, V., Ruiz-Artacho, P., Ruiz-Gimenez, N., Sahuquillo, J. C., Sala-Sainz, M. C., Samperiz, A., Sanchez-Martinez, R., Sanz, O., Soler, S., Sopena, B., Surinach, J. M., Torres, M. I., Uresandi, F., Usandizaga, E., Valero, B., Valle, R., Vela, J., Velez-Mendizabal, E., Vidal, G., Vila, M., Villalobos, A., Xifre, B., Vanassche, T., Verhamme, P., Yoo, H. H. B., Wells, P., Hirmerova, J., Maly, R., Salgado, E., Bertoletti, L., Bura-Riviere, A., Falvo, N., Farge-Bancel, D., Hij, A., Mahe, I., Moustafa, F., Braester, A., Brenner, B., Tzoran, I., Antonucci, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Bucherini, E., Candeloro, G., Cattabiani, C., Ciammaichella, M., Dentali, F., Di Micco, P., Duce, R., Giorgi-Pierfranceschi, M., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Pace, F., Parisi, R., Pellegrinet, M., Pesavento, R., Pinelli, M., Poggio, R., Prandoni, P., Quintavalla, R., Rocci, A., Tiraferri, E., Tonello, D., Tufano, A., Gibietis, V., Skride, A., Vitola, B., Bosevski, M., Zdraveska, M., Bounameaux, H., and Mazzolai, L.
Subjects: Male, Risk, medicine.medical_specialty, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Recurrence, Neoplasms, Thromboembolism, Internal medicine, Venous thrombosis, medicine, Humans, Cancer associated thrombosis, Recurrences, Registries, Mortality, Aged, Cancer, Aged, 80 and over, Prediction, Framingham Risk Score, business.industry, Mortality rate, Hematology, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Predictive value, Thrombosis, United States, Surgery, Patient Outcome Assessment, Research Design, 030220 oncology & carcinogenesis, Cohort, Female, business, Biomarkers
Abstract: SummaryEven though the Khorana risk score (KRS) has been validated to predict against the development of VTE among patients with cancer, it has a low positive predictive value. It is also unknown whether the score predicts outcomes in patients with cancer with established VTE. We selected a cohort of patients with active cancer from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the prognostic value of the KRS at inception in predicting the likelihood of VTE recurrences, major bleeding and mortality during the course of anticoagulant therapy. We analysed 7948 consecutive patients with cancer-associated VTE. Of these, 2253 (28 %) scored 0 points, 4550 (57 %) 1–2 points and 1145 (14 %) scored ≥3 points. During the course of anticoagulation, amongst patient with low, moderate and high risk KRS, the rate of VTE recurrences was of 6.21 (95 %CI: 4.99–7.63), 11.2 (95 %CI: 9.91–12.7) and 19.4 (95 %CI: 15.4–24.1) events per 100 patient-years; the rate of major bleeding of 5.24 (95 %CI: 4.13–6.56), 10.3 (95 %CI: 9.02–11.7) and 19.4 (95 %CI: 15.4–24.1) bleeds per 100 patient-years and the mortality rate of 25.3 (95 %CI: 22.8–28.0), 58.5 (95 %CI: 55.5–61.7) and 120 (95 %CI: 110–131) deaths per 100 patient-years, respectively. The C-statistic was 0.53 (0.50–0.56) for recurrent VTE, 0.56 (95 %CI: 0.54–0.59) for major bleeding and 0.54 (95 %CI: 0.52–0.56) for death. In conclusion, most VTEs occur in patients with low or moderate risk scores. The KRS did not accurately predict VTE recurrence, major bleeding, or mortality among patients with cancer-associated thrombosis.
Published: 2017

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

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

6. Systolic blood pressure and mortality in acute symptomatic pulmonary embolism

Author: Quezada, A, Jimenez, D, Bikdeli, B, Moores, L, Porres-Aguilar, M, Aramberri, M, Lima, J, Ballaz, A, Yusen, RD, Monreal, M, Prandoni, P, Brenner, B, Farge-Bancel, D, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Maly, R, Verhamme, P, Caprini, JA, Bui, HM, Adarraga, MD, Agud, M, Aibar, MA, Alfonso, J, Amado, C, Arcelus, JI, Azcarate-Aguero, P, Barbagelata, C, Barron, M, Barron-Andres, B, Blanco-Molina, A, Camon, AM, Canas, I, Carrasco, C, Castro, J, Cerda, P, Chasco, L, de Ancos, C, del Toro, J, Demelo, P, Diaz-Peromingo, JA, Diaz-Simon, R, Elias-Hernandez, T, Escribano, JC, Falga, C, Farfan, AI, Fernandez-Capitan, C, Fernandez-Criado, MC, de Roitegui, F, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin-Blanco, O, Gavin-Sebastian, O, Gayol, MC, Gil-Diaz, A, Gomez, V, Gomez-Cuervo, C, Gonzalez-Martinez, J, Grau, E, Gutierrez, J, Hernandez-Blasco, LM, Iglesias, M, Jara-Palomares, L, Jaras, MJ, Joya, MD, Jou, I, Lacruz, B, Lecumberri, R, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Nunez, JJ, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Madridano, O, Maestre, A, Marchena, PJ, del Pozo, M, Martin-Fortea, P, Martin-Martos, F, Martinez-Garcia, MA, Martinez-Gonzalez, L, Mellado, M, Moises, J, Montesa, C, Morales, MV, Nieto, JA, Nunez, MJ, Olivares, MC, Olivera, PE, Otalora, S, Otero, R, Panadero-Macia, M, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Perez-Jacoiste, A, Perez-Rus, G, Peris, ML, Porras, JA, Riera-Mestre, A, Rivas, A, Rodriguez-Cobo, A, Rodriguez-Hernandez, A, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Ruiz-Ruiz, J, Ruiz-Sada, P, Sahuquillo, JC, Sala-Sainz, MC, Salgueiro, G, Samperiz, A, Sanchez-Camara, S, Sanchez-Martinez, R, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Suarez, S, Surinach, JM, Tiberio, G, Tolosa, C, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valero, B, Valle, R, Vela, JR, Vidal, G, Villares, P, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Hirmerova, J, Salgado, E, Benzidia, I, Bura-Riviere, A, Debourdeau, P, Helfer, H, Hij, A, Mahe, I, Moustafa, F, Braester, A, Sharif-Kashani, B, Barillari, G, Bilora, F, Bortoluzzi, C, Brandolin, B, Ciammaichella, M, Dentali, F, Imbalzano, E, Landolfi, R, Maida, R, Mastroiacovo, D, Mumoli, N, Pace, F, Pesavento, R, Pomero, F, Quintavalla, R, Rocci, A, Siniscalchi, C, Tufano, A, Visona, A, Hong, NV, Zalunardo, B, Kalejs, RV, Skride, A, Strautmane, S, Zdraveska, M, Mazzolai, L, Caprini, J, Tafur, AJ, and RIETE Investigators
Subjects: Male, Cardiac & Cardiovascular Systems, Blood Pressure, 030204 cardiovascular system & hematology, GUIDELINES, THERAPY, 0302 clinical medicine, Cause of Death, EPIDEMIOLOGY, 030212 general & internal medicine, Prospective Studies, Registries, RISK, Aged, 80 and over, OUTCOMES, Pulmonary embolism, Survival Rate, Systolic blood pressure, Acute Disease, Cardiology, Female, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, Major bleeding, circulatory and respiratory physiology, medicine.medical_specialty, Canada, Systole, DIAGNOSIS, 03 medical and health sciences, Internal medicine, MANAGEMENT, medicine, Humans, In patient, cardiovascular diseases, Mortality, Aged, VENOUS THROMBOEMBOLISM, Science & Technology, business.industry, Odds ratio, medicine.disease, Confidence interval, United States, THROMBOSIS, Increased risk, Blood pressure, Spain, Cardiovascular System & Cardiology, PROGNOSTICATION, Pulmonary Embolism, business, Venous thromboembolism
Abstract: BACKGROUND: The optimal cutoff for systolic blood pressure (SBP) level to define high-risk pulmonary embolism (PE) remains to be defined. METHODS: To evaluate the relationship between SBP levels on admission and mortality in patients with acute symptomatic PE, the current study included 39,257 consecutive patients with acute symptomatic PE from the RIETE registry between 2001 and 2018. Primary outcomes included all-cause and PE-specific 30-day mortality. Secondary outcomes included major bleeding and recurrent venous thromboembolism (VTE). RESULTS: There was a linear inverse relationship between admission SBP and 30-day all-cause and PE-related mortality that persisted after multivariable adjustment. Patients in the lower SBP strata had higher rates of all-cause death (reference: SBP 110-129 mmHg) (adjusted odds ratio [OR] 2.9; 95% confidence interval [CI], 2.0-4.2 for SBP 190 mmHg). Consistent findings were also observed for 30-day PE-related death. CONCLUSIONS: In patients with acute symptomatic PE, a low SBP portends an increased risk of all-cause and PE-related mortality. The highest mortality was observed in patients with SBP
Published: 2019

7. Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries: analysis from the RIETE registry

Author: Mastroiacovo, Daniela, Dentali, Francesco, di Micco, Pierpaolo, Maestre, Ana, Jimenez, David, Soler, Silvia, Carles Sahuquillo, Joan, Verhamme, Peter, Fidalgo, Angeles, Lopez-Saez, Juan Bosco, Skride, Andris, Monreal, Manuel, Adarraga, MD, Aibar, MA, Alfonso, M, Alvarez, F, Arcelus, J, Ballaz, A, Banos, P, Barba, R, Barron, M, Barron-Andres, B, Bascunana, J, Blanco-Molina, A, Camon, AM, Chasco, L, Cruz, AJ, Pozo, R, de, Miguel J, del, Toro J, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Escribano, JC, Falga, C, Fernandez-Aracil, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gaya, I, Gomez, C, Gomez, V, Gonzalez, J, Grau, E, Guijarro, R, Gutierrez, J, Hernandez-Comes, G, Hernandez-Blasco, L, Hernando, E, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jimenez, R, Joya, MD, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Lumbierres, M, Madridano, O, Maestre, A, Marchena, PJ, Martin, M, Martin-Martos, F, Martin-Romero, M, Martinez, C, Monreal, M, Morales, M, Nieto, JA, Nieto, S, Nunez, A, Nunez, MJ, Odriozola, M, Olivares, MC, Otalora, S, Otero, R, Pardo, V, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Peris, ML, Pons, I, Porras, JA, Ramirez, L, Reyes, R, Riera-Mestre, A, Riesco, D, Rivas, A, Rodriguez-Davila, MA, Rosa, V, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Martinez, R, Soler, S, Surinach, JM, Tolosa, C, Torres, M, Trujillo-Santos, J, Uresandi, F, Usandizaga, E, Valero, B, Valle, R, Vela, J, Vicente, MP, Vilar, C, Villalobos, A, Vanassche, T, Vandenbriele, C, Verhamme, P, Yoo, HHB, Wells, P, Hirmerova, J, Maly, R, Salgado, E, Sanchez, GT, Bertoletti, L, Bura-Riviere, A, Falvo, N, Farge-Bancel, D, Hij, A, Mahe, I, Moustafa, F, Quere, I, Braester, A, Brenner, B, Ellis, M, Tzoran, I, Antonucci, G, Barillari, G, Bilora, F, Bortoluzzi, C, Brandolin, B, Bucherini, E, Camerota, A, Cattabiani, C, Ciammaichella, M, Dentali, F, Di Micco, P, Duce, R, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Lessiani, G, Maida, R, Mastroiacovo, D, Pace, F, Pesavento, R, Pinelli, M, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tiraferri, E, Tonello, D, Visona, A, Gibietis, V, Skride, A, Vitola, B, Zdraveska, M, Alatri, A, Bounameaux, H, Calanca, L, Mazzolai, L, University of Insubria, Varese, Instituto Ramon y Cajal de Investigacion Sanitaria [Madrid, Spain] (IRYCIS), Universidad de Alcalá - University of Alcalá (UAH), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, Risk, medicine.medical_specialty, Multivariate analysis, Adolescent, International Cooperation, MEDLINE, RIETE Investigators, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Outpatients, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Registries, Young adult, Duration (project management), Israel, Prospective cohort study, Child, ComputingMilieux_MISCELLANEOUS, Aged, business.industry, Length of Stay, Middle Aged, medicine.disease, Patient Discharge, 3. Good health, Pulmonary embolism, Clinical Practice, 030228 respiratory system, Italy, Spain, Emergency medicine, Acute Disease, Multivariate Analysis, Observational study, Female, France, business, Pulmonary Embolism, Software, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Real-life data from the RIETE study suggest only a few patients with pulmonary embolism at low risk of complications were treated at home or hospitalised for ≤5 days. Management of PE appeared quite variable in different countries.http://ow.ly/o2b230mD8EY
Published: 2019

8. Vena cava filters in patients presenting with major bleeding during anticoagulation for venous thromboembolism

Author: Mellado, M, Trujillo-Santos, J, Bikdeli, B, Jimenez, D, Nunez, MJ, Ellis, M, Marchena, PJ, Vela, JR, Clara, A, Moustafa, F, Monreal, M, Adarraga, MD, Aibar, MA, Alfonso, M, Arcelus, JI, Ballaz, A, Banos, P, Barba, R, Barron, M, Bascunana, J, Blanco-Molina, A, Camon, AM, Carrasco, C, Chasco, L, Cruz, AJ, Del, PR, Del, TJ, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Encabo, M, Falga, C, Fernandez-Aracil, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Garcia-Sanchez, I, Gavin, O, Gomez, C, Gomez, V, Gonzalez, J, Grau, E, Guijarro, R, Guirado, L, Gutierrez, J, Hernandez-Blasco, L, Hernando, E, Isern, V, Jara-Palomares, L, Jaras, MJ, Joya, MD, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Madridano, O, Maestre, A, Martin, M, Martin-Martos, F, Morales, MV, Nieto, JA, Olivares, MC, Otalora, S, Otero, R, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Peris, ML, Pons, I, Porras, JA, Riera-Mestre, A, Rivas, A, Rodriguez-Davila, MA, Rodriguez-Galan, I, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Artola, B, Sanchez-Martinez, R, Sancho, T, Soler, S, Soto, MJ, Surinach, JM, Tolosa, C, Torres, MI, Uresandi, F, Usandizaga, E, Valero, B, Valle, R, Vela, J, Vidal, G, Villalobos, A, Xifre, B, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Verhamme, P, Yoo, HHB, Wells, P, Hirmerova, J, Maly, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Falvo, N, Farge-Bancel, D, Hij, A, Merah, A, Mahe, I, Quere, I, Braester, A, Brenner, B, Tzoran, I, Antonucci, G, Bilora, F, Bucherini, E, Cattabiani, C, Ciammaichella, M, Dentali, F, Di Micco, P, Doddi, M, Duce, R, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Lessiani, G, Maggi, F, Maida, R, Mastroiacovo, D, Pace, F, Pesavento, R, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tiraferri, E, Tonello, D, Visona, A, Zalunardo, B, Gibietis, V, Skride, A, Vitola, B, Zdraveska, M, Bounameaux, H, Calanca, L, Fresa, M, and Mazzolai, L
Subjects: Male, medicine.medical_specialty, Vena Cava Filters, Inferior vena cava filter, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, Statistics, Nonparametric, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Thromboembolism, Anticoagulants, Bleeding, Mortality, Vena cava filter, Venous thromboembolism, Internal Medicine, medicine, Humans, Registries, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Mortality rate, Heparin, Middle Aged, Surgery, Clinical trial, Treatment Outcome, Propensity score matching, Emergency Medicine, Female, business, Major bleeding, medicine.drug
Abstract: The association between inferior vena cava filter (IVC) use and outcome in patients presenting with major bleeding during anticoagulation for venous thromboembolism (VTE) has not been thoroughly investigated. We used the RIETE registry to compare the 30-day outcomes (death, major re-bleeding or VTE recurrences) in VTE patients who bled during the first 3 months of therapy, regarding the insertion of an IVC filter. A propensity score matched (PSM) analysis was performed to adjust for potential confounders. From January 2001 to September 2016, 1065 VTE patients had major bleeding during the first 3 months of anticoagulation (gastrointestinal 370; intracranial 124). Of these, 122 patients (11%) received an IVC filter. Patients receiving a filter restarted anticoagulation later (median, 4 vs. 2 days) and at lower doses (95 +/- 52 IU/kg/day vs. 104 +/- 55 of low-molecular-weight heparin) than those not receiving a filter. During the first 30 days after bleeding (after excluding 246 patients who died within the first 24 h), 283 patients (27%) died, 63 (5.9%) had non-fatal re-bleeding and 19 (1.8%) had recurrent pulmonary embolism (PE). In PSM analysis, patients receiving an IVC filter (n = 122) had a lower risk for all-cause death (HR 0.49; 95% CI 0.31-0.77) or fatal bleeding (HR 0.16; 95% CI 0.07-0.49) and a similar risk for re-bleeding (HR 0.55; 95% CI 0.23-1.40) or PE recurrences (HR 1.57; 95% CI 0.38-6.36) than those not receiving a filter (n = 429). In VTE patients experiencing major bleeding during the first 3 months, use of an IVC filter was associated with reduced mortality rates. Clinical Trial Registration NCT02832245.
Published: 2019

9. Clinical outcome in patients with venous thromboembolism receiving concomitant anticoagulant and antiplatelet therapy

Author: Tzoran I., Brenner B., Sakharov G., Trujillo-Santos J., Lorenzo A., Madridano O., Lopez-Saez J. B., Monreal M., Andujar V., Arcelus J. I., Auguet T., Barba R., Barron M., Barron-Andres B., Bascunana J., Blanco-Molina A., Bueso T., Casado I., Casillas C., Conget F., Del Molino F., Del Toro J., Falga C., Fernandez-Capitan C., Font L., Gallego P., Garcia-Bragado F., Gomez V., Gonzalez J., Gonzalez-Bachs E., Guijarro R., Guil M., Gutierrez J., Hernandez L., Hernandez-Huerta S., Jara-Palomares L., Jaras M. J., Jimenez D., Jimenez R., Lobo J. L., Lopez-Jimenez L., Lopez-Montes L., Lopez-Reyes R., Lorente M. A., Luque J. M., Llutart J., Marchena P. J., Martin M., Martin-Antoran J. M., Mellado M., Nauffal D., Nieto J. A., Ogea J. L., Otero R., Pagan B., Pedrajas J. M., Peris M. L., Porras J. A., Pons I., Riera-Mestre A., Rivas A., Rodriguez-Davila M. A., Roman P., Roncero A., Rosa V., Ruiz-Gimenez N., Ruiz J., Sabio P., Sahuquillo J. C., Samperiz A., Sanchez R., Sanchez Munoz-Torrero J. F., Soler S., Surinach J. M., Tiberio G., Tirado R., Tolosa C., Valero B., Valle R., Vela J., Vidal G., Villalobos A., Vilella V., Malfante P., Villagra M., Vivero F., Verhamme P., Peerlinck K., Maly R., Hirmerova J., Kaletova M., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Grange C., Hij A., Mahe I., Merah A., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Zeltser D., Apollonio A., Barillari G., Ciammaichella M., Di Micco P., Duce R., Guida A., Maida R., Mattei L., Pace F., Piovella C., Pesavento R., Poggio R., Prandoni P., Rota L., Schenone A., Tonello D., Tufano A., Visona A., Zalunardo B., Santos M., Bosevski M., Kovacevic D., Alatri A., Bounameaux H., Calanca L., Mazzolai L., Serrano J. C., Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Tzoran, I., Brenner, B., Sakharov, G., Trujillo-Santos, J., Lorenzo, A., Madridano, O., Lopez-Saez, J. B., Monreal, M., Andujar, V., Arcelus, J. I., Auguet, T., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Casado, I., Casillas, C., Conget, F., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Font, L., Gallego, P., Garcia-Bragado, F., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Guijarro, R., Guil, M., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, R., Lobo, J. L., Lopez-Jimenez, L., Lopez-Montes, L., Lopez-Reyes, R., Lorente, M. A., Luque, J. M., Llutart, J., Marchena, P. J., Martin, M., Martin-Antoran, J. M., Mellado, M., Nauffal, D., Nieto, J. A., Ogea, J. L., Otero, R., Pagan, B., Pedrajas, J. M., Peris, M. L., Porras, J. A., Pons, I., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Roncero, A., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Sabio, P., Sahuquillo, J. C., Samperiz, A., Sanchez, R., Sanchez Munoz-Torrero, J. F., Soler, S., Surinach, J. M., Tiberio, G., Tirado, R., Tolosa, C., Valero, B., Valle, R., Vela, J., Vidal, G., Villalobos, A., Vilella, V., Malfante, P., Villagra, M., Vivero, F., Verhamme, P., Peerlinck, K., Maly, R., Hirmerova, J., Kaletova, M., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Grange, C., Hij, A., Mahe, I., Merah, A., Quere, I., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Zeltser, D., Apollonio, A., Barillari, G., Ciammaichella, M., Di Micco, P., Duce, R., Guida, A., Maida, R., Mattei, L., Pace, F., Piovella, C., Pesavento, R., Poggio, R., Prandoni, P., Rota, L., Schenone, A., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Santos, M., Bosevski, M., Kovacevic, D., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., and Serrano, J. C.
Subjects: Male, medicine.medical_specialty, Arterial disease, medicine.drug_class, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, medicine, Antiplatelet, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Aged, business.industry, Anticoagulant, Anticoagulants, Venous Thromboembolism, 3. Good health, Surgery, Treatment Outcome, Increased risk, Anticoagulant therapy, Concomitant, Drug Therapy, Combination, Female, business, Venous thromboembolism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Platelet Aggregation Inhibitors, Major bleeding
Abstract: International audience; INTRODUCTION:Patients with arterial disease receiving antiplatelet agents may develop venous thromboembolism (VTE) and need anticoagulant therapy, although concomitant use of these drugs may increase bleeding risk. We analyzed RIETE data and compared clinical outcomes depending on decision to discontinue or maintain antiplatelet therapy at VTE diagnosis.METHODS:Consecutive patients with acute VTE were enrolled in RIETE. Only patients receiving antiplatelet therapy at baseline were included in this analysis. Primary outcomes were: rate of subsequent ischemic events, major bleeding or death during anticoagulation course.RESULTS:1178 patients who received antiplatelet drugs at VTE diagnosis were included. Antiplatelet therapy was discontinued in 62% of patients. During anticoagulation course, patients also receiving antiplatelet therapy had higher rates of lower limb amputations (2.28 vs. 0.21 events per 100 patients-years; p
Published: 2014

10. Real-life Use of Anticoagulants in Venous Thromboembolism With a Focus on Patients With Exclusion Criteria for Direct Oral Anticoagulants

Author: Moustafa, F., Pesavento, R., di Micco, P., Gonzalez-Martinez, J., Quintavalla, R., Peris, M. -L., Porras, J. A., Falvo, N., Banos, P., Monreal, M., Adarraga, M. D., Aibar, M. A., Alfonso, M., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Camon, A. M., Chasco, L., del Pozo, R., de Miguel, J., del Toro, J., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Falga, C., Fernandez-Aracil, C., Fernandez-Capitan, C., Fidalgo, M. A., Font, C., Font, L., Gallego, P., Garcia, M. A., Garcia-Bragado, M. F., Garcia-Morillo, M., Garcia-Raso, A., Gavin, O., Gil, F., Gomez, C., Gomez, V., Gonzalez, J., Grau, E., Grimon, A., Guijarro, R., Gutierrez, J., Hernandez-Comes, H., Hernandez-Blasco, G., Hernando, E., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Joya, M. D., Llamas, P., Lobo, J. L., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Lumbierres, M., Madridano, O., Maestre, A., Marchena, P. J., Martin-Asenjo, M., Martin-Martos, F., Martin-Romero, M., Miralles, M., Morales, M. V., Moya, E. M., Munoz, C., Nieto, J. A., Nieto, S., Nunez, A., Nunez, M. J., Odriozola, M., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Perez-Ductor, C., Peris, M. L., Pons, I., Ramirez, L., Riera-Mestre, A., Riesco, D., Rivas, A., Rodriguez, M., Rodriguez-Davila, M. A., Rosa, V., Rosillo-Hernandez, E. M., Ruiz-Artacho, P., Sahuquillo, J. C., Sala-Sainz, M. C., Samperiz, A., Sanchez-Martinez, R., Soler, S., Surinach, J. M., Tolosa, C., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valero, B., Valle, R., Vela, J., Vela, L., Vidal, G., Villalobos, A., Vanassche, T., Verhamme, P., Yoo, H. H. B., Wells, P., Hirmerova, J., Maly, R., Salgado, E., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Quere, I., Braester, A., Brenner, B., Ellis, M., Tzoran, I., Andriulli, M., Antonucci, G., Barillari, G., Bortoluzzi, C., Brandolin, B., Bucherini, E., Cattabiani, C., Ciammaichella, M., Dentali, F., Di Micco, P., Duce, R., Giorgipierfranceschi, M., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Pace, F., Pinelli, M., Poggio, R., Prandoni, P., Rocci, A., Siniscalchi, C., Tiraferri, E., Visona, A., Zalunardo, B., Gibietis, V., Skride, A., Vitola, B., Zdraveska, M., Bounameaux, H., and Mazzolai, L.
Subjects: Male, medicine.medical_specialty, medicine.drug_class, Long Term Adverse Effects, Hemorrhage, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, law, Recurrence, Internal medicine, medicine, Humans, Pharmacology (medical), In patient, 030212 general & internal medicine, Aged, Randomized Controlled Trials as Topic, Pharmacology, business.industry, Heparin, Patient Selection, Anticoagulant, Hazard ratio, Anticoagulants, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, Confidence interval, Treatment Outcome, Female, business, Venous thromboembolism, medicine.drug, Factor Xa Inhibitors
Abstract: We assessed the real-life use of direct oral anticoagulants (DOACs) in patients with venous thromboembolism (VTE) and exclusion criteria for randomized trials. From 2013 to 2016, 3,578 of 18,853 patients (19%) had exclusion criteria. Irrespective of which anticoagulant was chosen, they had more VTE recurrences (hazard ratio (HR): 3.10; 95% confidence interval (CI): 2.47-3.88), major bleeds (HR: 4.10; 95% CI: 3.38-4.96), and deaths (HR: 9.47; 95% CI: 8.46-10.6) than those without exclusion criteria. During initial therapy, no patient with exclusion criteria on DOACs (n = 115) recurred, but those on rivaroxaban bled less often (adjusted HR: 0.18; 95% CI: 0.04-0.79) than those on unfractionated heparin (n = 224) and similar to those (n = 3,172) on low-molecular-weight (LMWH) heparin. For long-term therapy, patients on rivaroxaban (n = 151) had nonsignificantly fewer VTE recurrences (adjusted HR: 0.74; 95% CI: 0.08-1.32) and major bleeds (adjusted HR: 0.41; 95% CI: 0.15-1.15) than those on LMWH (n = 2,071). The efficacy and safety of DOACs were similar to standard therapy.
Published: 2018

11. Outcomes in Neurosurgical Patients Who Develop Venous Thromboembolism

Author: Cote, L. P., Greenberg, S., Caprini, J. A., Stone, J., Arcelus, J. I., Lopez Jimenez, L., Rosa, V., Schellong, S., Monreal, M., Arcelus, Ji, Ballaz, A, Barba, R, Barrón, M, Barrón Andrés, B, Bascuñana, J, Bedate, P, Blanco Molina, A, Bueso, T, Casado, I, Conget, F, del Molino, F, del Toro, J, Falgá, C, Fernández Capitán, C, Font, C, Fuentes, Mi, Gallego, P, García Bragado, F, Gavín, O, Gómez, V, González, J, González Bachs, E, Grau, E, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Hernández Huerta, S, Jara Palomares, L, Jaras, Mj, Jiménez, D, Lobo, Jl, López Jiménez, L, López Sáez JB, Lorente, Ma, Lorenzo, A, Luque, Jm, Madridano, O, Macià, M, Maestre, A, Marchena, Pj, Martín, M, Monreal, M, Mora, Jm, Mosquera, D, Muñoz, Fj, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Peris, Ml, Raissouni, N, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Rosa, V, Ruiz, J, Ruiz Ribó MD, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Tiberio, G, Tilvan, Rm, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vela, J, Villalobos, A, Villalta, J, Malý, R, Hirmerova, J, Bertoletti, L, Bura Riviere, A, Farge Bancel, D, Grange, C, Hij, A, Mahe, I, Merah, A, Quere, I, Schellong, S, Babalis, D, Papadakis, M, Tzinieris, I, Braester, A, Brenner, B, Tzoran, I, Zeltser, D, Barillari, G, Ciammaichella, M, Di Micco, P, Duce, R, Pasca, S, Pesavento, R, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rocci, A, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Barbosa, Al, Gonçalves, F, Rodrigues, Am, Santos, M, Saraiva, M, Bosevski, M, Kovacevic, D, Alatri, A, Aujeski, D, Bounameaux, H, Calanca, L, Mazzolai, L, and Caprini, J.
Subjects: Adult, Male, medicine.medical_specialty, business.industry, Anticoagulants, Venous Thromboembolism, Hematology, General Medicine, Middle Aged, medicine.disease, Neurosurgical Procedures, 3. Good health, Pulmonary embolism, Postoperative Complications, Humans, Medicine, Female, Registries, Pulmonary Embolism, business, Intensive care medicine, Venous thromboembolism, Aged
Abstract: Objectives: Registro Informatizado de Enfermedad TromboEmbólica (RIETE) database was used to investigate whether neurosurgical patients with venous thromboembolism (VTE) were more likely to die of bleeding or VTE and the influence of anticoagulation on these outcomes. Methods: Clinical characteristics, treatment details, and 3-month outcomes were assessed in those who developed VTE after neurosurgery. Results: Of 40 663 patients enrolled, 392 (0.96%) had VTE in less than 60 days after neurosurgery. Most patients in the cohort (89%) received initial therapy with low-molecular-weight heparin, (33% received subtherapeutic doses). In the first week, 10 (2.6%) patients died (8 with pulmonary embolism [PE], no bleeding deaths; P = .005). After the first week, 20 (5.1%) patients died (2 with fatal bleeding, none from PE). Overall, this cohort was more likely to develop a fatal PE than a fatal bleed (8 vs 2 deaths, P = .058). Conclusions: Neurosurgical patients developing VTE were more likely to die from PE than from bleeding in the first week, despite anticoagulation.
Published: 2014

12. D-dimer levels and 90-day outcome in patients with acute pulmonary embolism with or without cancer

Author: Ana, Maestre, Javier Trujillo Santos, Adriana, Visoná, José Luís Lobo, Enric, Grau, Radovan, Malý, Rita, Duce, Manuel, Monreal, Alcalde, M, Arcelus, Ji, Ballaz, A, Barba, R, Barrón, M, Barrón Andrés, B, Bascuñana, J, Bedate, P, Blanco Molina, A, Bueso, T, Casado, I, Conget, F, del Molino, F, del Toro, J, Falgá, C, Fernández Capitán, C, Fuentes, Mi, Gallego, P, García, J, García Bragado, F, Gavín, O, Gómez, V, González, J, González Bachs, E, Grau, E, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Jara Palomares, L, Jaras, Mj, Jiménez, D, Jiménez, S, Lobo, Jl, López Jiménez, L, López Sáez JB, Lorente, Ma, Lorenzo, A, Luque, Jm, Madridano, O, Macià, M, Maestre, A, Marchena, Pj, Martín, M, Monreal, M, Mora, Jm, Muñoz, Fj, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Peris, Ml, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Rosa, V, Ruiz, J, Ruiz Ribó MD, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Tiberio, G, Tilvan, Rm, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vela, J, Vidal, G, Villalobos, A, Villalta, J, Malý, R, Hirmerova, J, Tomko, T, Bertoletti, L, Bura Riviere, A, Farge Bancel, D, Grange, C, Hij, A, Mahe, I, Merah, A, Quere, I, Schellong, S, Babalis, D, Papadakis, M, Tzinieris, I, Braester, A, Brenner, B, Tzoran, I, Zeltser, D, Barillari, G, Ciammaichella, M, Dalla Valle, F, Di Micco, P, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rocci, A, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Brinquinho, M, Gomes, D, Gonçalves, F, Santos, M, Saraiva, M, Bosevski, M, Kovacevic, D, Alatri, A, Aujeski, D, Bounameaux, H, Calanca, L, Mazzolai, L., Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)
Subjects: Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Gastroenterology, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Neoplasms, Internal medicine, D-dimer, medicine, Humans, In patient, 030212 general & internal medicine, Aged, business.industry, Anticoagulants, Cancer, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, Prognosis, medicine.disease, 3. Good health, Pulmonary embolism, Quartile, Cardiology, Female, Registry data, Pulmonary Embolism, business
Abstract: International audience; BACKGROUND:The prognostic value of D-dimer testing in patients with acute pulmonary embolism (PE) has not been thoroughly studied.METHODS:We used the RIETE Registry data to assess the 90-day prognostic value of increased IL Test D-dimer levels at baseline in patients with PE, according to the presence or absence of cancer.RESULTS:As of May 2013, 3,283 patients with acute PE underwent D-dimer testing using IL Test D-dimer. Among 2,588 patients without cancer, those with D-dimer levels in the highest quartile had a higher rate of fatal PE (2.6% vs. 0.9%; p=0.002), fatal bleeding (1.1% vs. 0.3%; p=0.017) and all-cause death (9.1% vs. 4.4%; p
Published: 2014

13. Fondaparinux in the initial and long-term treatment of venous thromboembolism

Author: Pesavento R., Amitrano M., Trujillo-Santos J., Di Micco P., Mangiacapra S., Lopez-Jimenez L., Falga C., Garcia-Bragado F., Piovella C., Prandoni P., Monreal M., Adarraga M. D., Alvarado A. V., Arcelus J. I., Barba R., Barron M., Barron-Andres B., Bascunana J., Benitez J. F., Blanco-Molina A., Casado I., Conget F., Chaves E. L., De Ancos C., Del Molino F., Del Toro J., Farfan A. I., Fernandez-Capitan C., Font L., Gallego P., Gomez V., Gonzalez J., Gonzalez-Marcano D., Grau E., Guijarro R., Gutierrez J., Hernandez L., Hernandez-Huerta S., Jara-Palomares L., Jaras M. J., Jimenez D., Lecumberri R., Lobo J. L., Lopez-Montes L., Lopez-Reyes R., Lopez-Saez J. B., Lorente M. A., Lorenzo A., Luque J. M., Madridano O., Marchena P. J., Martin-Antoran J. M., Mellado M., Morales M. V., Nauffal D., Nieto J. A., Nunez M. J., Otero R., Pagan B., Pedrajas J. M., Peris M. L., Pons I., Porras J. A., Puerta P., Riera-Mestre A., Rivas A., Rodriguez-Davila M. A., Roman P., Rosa V., Ruiz-Gimenez N., Ruiz J., Samperiz A., Sanchez R., Soler S., Soto M. J., Surinach J. M., Tiberio G., Tilvan R. M., Tirado R., Uresandi F., Valero B., Valle R., Vela J., Villalobos A., Malfante P., Matias V., Vivero F., Verhamme P., Peerlinck K., Wells P., Maly R., Hirmerova J., Salgado E., Bertoletti L., Bura-Riviere A., Moustafa F., Farge-Bancel D., Hij A., Mahe I., Merah A., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Zeltser D., Apollonio A., Barillari G., Cannavaccioulo F., Ciammaichella M., Dentali F., Enea I., Guida A., Maida R., Pace F., Pasca S., Rota L., Tiraferri E., Tufano A., Visona A., Mesquita P., Ribeiro De Almeida J. L., Sousa M. S., Bosevski M., Zdraveska M., Alatri A., Bounameaux H., Calanca L., Mazzolai L., Serrano J. C., Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Pesavento, R., Amitrano, M., Trujillo-Santos, J., Di Micco, P., Mangiacapra, S., Lopez-Jimenez, L., Falga, C., Garcia-Bragado, F., Piovella, C., Prandoni, P., Monreal, M., Adarraga, M. D., Alvarado, A. V., Arcelus, J. I., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Benitez, J. F., Blanco-Molina, A., Casado, I., Conget, F., Chaves, E. L., De Ancos, C., Del Molino, F., Del Toro, J., Farfan, A. I., Fernandez-Capitan, C., Font, L., Gallego, P., Gomez, V., Gonzalez, J., Gonzalez-Marcano, D., Grau, E., Guijarro, R., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Lecumberri, R., Lobo, J. L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Luque, J. M., Madridano, O., Marchena, P. J., Martin-Antoran, J. M., Mellado, M., Morales, M. V., Nauffal, D., Nieto, J. A., Nunez, M. J., Otero, R., Pagan, B., Pedrajas, J. M., Peris, M. L., Pons, I., Porras, J. A., Puerta, P., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Samperiz, A., Sanchez, R., Soler, S., Soto, M. J., Surinach, J. M., Tiberio, G., Tilvan, R. M., Tirado, R., Uresandi, F., Valero, B., Valle, R., Vela, J., Villalobos, A., Malfante, P., Matias, V., Vivero, F., Verhamme, P., Peerlinck, K., Wells, P., Maly, R., Hirmerova, J., Salgado, E., Bertoletti, L., Bura-Riviere, A., Moustafa, F., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Quere, I., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Apollonio, A., Barillari, G., Cannavaccioulo, F., Ciammaichella, M., Dentali, F., Enea, I., Guida, A., Maida, R., Pace, F., Pasca, S., Rota, L., Tiraferri, E., Tufano, A., Visona, A., Mesquita, P., Ribeiro De Almeida, J. L., Sousa, M. S., Bosevski, M., Zdraveska, M., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., and Serrano, J. C.
Subjects: Male, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Fondaparinux, Pharmacotherapy, Anticoagulants, Deep vein thrombosis, Drug therapy, Pulmonary embolism, Venous thromboembolism, Female, Humans, Middle Aged, Polysaccharides, Treatment Outcome, Venous Thromboembolism, Hematology, Deep vein thrombosi, Internal medicine, medicine, business.industry, Anticoagulant, Cancer, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Heparin, medicine.disease, Confidence interval, 3. Good health, Surgery, business, medicine.drug
Abstract: International audience; BACKGROUND:Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice.METHODS:We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer.RESULTS:Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p
Published: 2015

14. Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

Author: Mahe, I., Sterpu, R., Bertoletti, L., Lopez-Jimenez, L., Joan, M. M., Trujillo-Santos, J., Ballaz, A., Hernandez Blasco, L. M., Marchena, P. J., Monreal, M., Ameneiro, E., Arcelus, J. I., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Casado, I., Conget, F., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Font, L., Fuentes, M. I., Gallego, P., Garcia-Bragado, F., Garcia-Lorenzo, M. D., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Guil, M., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jaras, M. J., Jimenez, D., Lecumberri, R., Lobo, J. L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Luque, J. M., Madridano, O., Martin, M., Mellado, M., Mora, J. M., Nauffal, D., Nieto, J. A., Nunez, M. J., Ogea, J. L., Paul, H., Pedrajas, J. M., Peris, M. L., Porras, J. A., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Sahuquillo, J. C., Samperiz, A., Sanchez, R., Sanchez Munoz-Torrero, J. F., Soler, S., Surinach, J. M., Tiberio, G., Tilvan, R. M., Tolosa, C., Uresandi, F., Valdes, M., Valero, B., Valle, R., Vela, J., Vidal, G., Vilella, V., Villalta, J., Verhamme, P., Peerlinck, K., Wells, P., Maly, R., Hirmerova, J., Kaletova, M., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Merah, A., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Amitrano, M., Apollonio, A., Barillari, G., Ciammaichella, M., Dalla Valle, F., Di Micco, P., Duce, R., Guida, A., Maida, R., Pasca, S., Piovella, C., Prandoni, P., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Brinquinho, M., Miranda, D., Sousa, M. S., Bosevski, M., Kovacevic, D., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., RIETE Investigators, Ameneiro, E., Arcelus, JI., Ballaz, A., Barba, R., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Blanco-Molina, A., Bueso, T., Casado, I., Conget, F., del Molino, F., del Toro, J., Falgá, C., Fernández-Capitán, C., Font, L., Fuentes, MI., Gallego, P., García-Bragado, F., García-Lorenzo, MD., Gómez, V., González, J., González-Bachs, E., Guil, M., Gutiérrez, J., Hernández, L., Hernández-Huerta, S., Jaras, MJ., Jiménez, D., Lecumberri, R., Lobo, JL., López-Jiménez, L., López-Montes, L., López-Reyes, R., López-Sáez, JB., Lorente, MA., Lorenzo, A., Luque, JM., Madridano, O., Marchena, PJ., Martín, M., Mellado, M., Monreal, M., Mora, JM., Nauffal, D., Nieto, JA., Núñez, MJ., Ogea, JL., Paul, H., Pedrajas, JM., Peris, ML., Porras, JA., Riera-Mestre, A., Rivas, A., Rodríguez-Dávila, MA., Román, P., Rosa, V., Ruiz-Giménez, N., Ruiz, J., Sahuquillo, JC., Samperiz, A., Sánchez, R., Sánchez Muñoz-Torrero JF., Soler, S., Suriñach, JM., Tiberio, G., Tilván, RM., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valdés, M., Valero, B., Valle, R., Vela, J., Vidal, G., Vilella, V., Villalta, J., Verhamme, P., Peerlinck, K., Wells, P., Malý, R., Hirmerova, J., Kaletova, M., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Amitrano, M., Apollonio, A., Barillari, G., Ciammaichella, M., Dalla Valle, F., Di Micco, P., Duce, R., Guida, A., Maida, R., Pasca, S., Piovella, C., Prandoni, P., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visonà, A., Zalunardo, B., Brinquinho, M., Miranda, D., Bosevski, M., Kovacevic, D., Alatri, A., Bounameaux, H., Calanca, L., Sterpu, R., Lopez-Jimenez, L., Joan, M. M., Hernandez Blasco, L. M., Marchena, P. J., Arcelus, J. I., Barron, M., Barron-Andres, B., Bascunana, J., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Fuentes, M. I., Garcia-Bragado, F., Garcia-Lorenzo, M. D., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jaras, M. J., Jimenez, D., Lobo, J. L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Luque, J. M., Martin, M., Mora, J. M., Nieto, J. A., Nunez, M. J., Ogea, J. L., Pedrajas, J. M., Peris, M. L., Porras, J. A., Rodriguez-Davila, M. A., Roman, P., Ruiz-Gimenez, N., Sahuquillo, J. C., Sanchez, R., Sanchez Munoz-Torrero, J. F., Surinach, J. M., Tilvan, R. M., Valdes, M., Maly, R., Visona, A., Sousa, M. S., and Mazzolai, L.
Subjects: Male, Time Factors, Vitamin K, lcsh:Medicine, Càncer de ronyó, Deep vein thrombosis, Neoplasms, Antithrombotic, 80 and over, lcsh:Science, Aged, 80 and over, Multidisciplinary, Anticoagulant, Low-Molecular-Weight, Anemia, Venous Thromboembolism, Heparin, Aged, Anticoagulants, Drug Prescriptions, Female, Fibrinolytic Agents, Follow-Up Studies, Guideline Adherence, Heparin, Low-Molecular-Weight, Humans, Middle Aged, 3. Good health, Renal cancer, Cancer treatment, Venous thromboembolism, Research Article, medicine.drug, medicine.medical_specialty, medicine.drug_class, Hemorrhage, Thromboembolism, Internal medicine, medicine, Anticoagulant therapy, Tromboembolisme, Trombosi -- Tractament, business.industry, lcsh:R, Cancer, Odds ratio, medicine.disease, Surgery, Anticoagulants (Medicina), lcsh:Q, Anticoagulants (Medicine), business, Fibrinolytic agent
Abstract: Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision. This Registry is supported by unrestricted educational grants from Sanofi Spain and Bayer Pharma AG. The funding source had no role in the design, protocol development, or conduct of the study; data collection, management, or analysis; interpretation, preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The RIETE Registry was supported with an unrestricted educational grant from Sanofi Spain and Bayer Pharma AG. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain, which accounts for a 20.05% of the total patients included in the RIETE Registry. The authors have nothing to disclose. The authors have declared that no competing interests exist.
Published: 2015

15. Fatal Events in Cancer Patients Receiving Anticoagulant Therapy for Venous Thromboembolism

Author: Farge D., Trujillo-Santos J., Debourdeau P., Bura-Riviere A., Rodriguez-Beltran E. M., Nieto J. A., Peris M. L., Zeltser D., Mazzolai L., Hij A., Monreal M., Durante A., Alcalde M., Arcelus J. I., Ballaz A., Barba R., Barron M., Barron-Andres B., Bascunana J., Bedate P., Blanco-Molina A., Bueso T., Casado I., Conget F., Del Molino F., Del Toro J., Falga C., Fernandez-Capitan C., Fuentes M. I., Gallego P., Garcia J., Garcia-Bragado F., Gavin O., Gomez V., Gonzalez J., Gonzalez-Bachs E., Grau E., Guil M., Guijarro R., Gutierrez J., Hernandez L., Jara-Palomares L., Jaras M. J., Jimenez D., Jimenez S., Lobo J. L., Lopez-Jimenez L., Lopez-Saez J. B., Lorente M. A., Lorenzo A., Luque J. M., Madridano O., Macia M., Maestre A., Marchena P. J., Martin M., Mora J. M., Munoz F. J., Nauffal M. D., Nunez M. J., Ogea J. L., Otero R., Pedrajas J. M., Riera-Mestre A., Rivas A., Rodriguez-Davila M. A., Roman P., Rosa V., Ruiz J., Ruiz-Ribo M. D., Ruiz-Gamietea A., Ruiz-Gimenez N., Sahuquillo J. C., Samperiz A., Sanchez Munoz-Torrero J. F., Soler S., Tiberio G., Tilvan R. M., Tolosa C., Trujillo J., Uresandi F., Valdes M., Valero B., Valle R., Vela J., Vidal G., Villalobos A., Villalta J., Gadelha T., Maly R., Hirmerova J., Tomko T., Bertoletti L., Farge-Bancel D., Grange C., Mahe I., Merah A., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Faul J., Braester A., Brenner B., Tzoran I., Barillari G., Ciammaichella M., Dalla Valle F., Di Micco P., Duce R., Maida R., Pasca S., Piovella C., Poggio R., Prandoni P., Quintavalla R., Rocci A., Rota L., Schenone A., Tiraferri E., Tonello D., Tufano A., Visona A., Zalunardo B., Brinquinho M., Gomes D., Goncalves F., Santos M., Saraiva M., Bosevski M., Kovacevic D., Alatri A., Aujeski D., Bounameaux H., Calanca L., Caprini J., RIETE Investigators, Farge, D., Trujillo-Santos, J., Debourdeau, P., Bura-Riviere, A., Rodriguez-Beltran, E. M., Nieto, J. A., Peris, M. L., Zeltser, D., Mazzolai, L., Hij, A., Monreal, M., Durante, A., Alcalde, M., Arcelus, J. I., Ballaz, A., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Bedate, P., Blanco-Molina, A., Bueso, T., Casado, I., Conget, F., Del Molino, F., Del Toro, J., Falga, C., Fernandez-Capitan, C., Fuentes, M. I., Gallego, P., Garcia, J., Garcia-Bragado, F., Gavin, O., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Grau, E., Guil, M., Guijarro, R., Gutierrez, J., Hernandez, L., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, S., Lobo, J. L., Lopez-Jimenez, L., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Luque, J. M., Madridano, O., Macia, M., Maestre, A., Marchena, P. J., Martin, M., Mora, J. M., Munoz, F. J., Nauffal, M. D., Nunez, M. J., Ogea, J. L., Otero, R., Pedrajas, J. M., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Rosa, V., Ruiz, J., Ruiz-Ribo, M. D., Ruiz-Gamietea, A., Ruiz-Gimenez, N., Sahuquillo, J. C., Samperiz, A., Sanchez Munoz-Torrero, J. F., Soler, S., Tiberio, G., Tilvan, R. M., Tolosa, C., Trujillo, J., Uresandi, F., Valdes, M., Valero, B., Valle, R., Vela, J., Vidal, G., Villalobos, A., Villalta, J., Gadelha, T., Maly, R., Hirmerova, J., Tomko, T., Bertoletti, L., Farge-Bancel, D., Grange, C., Mahe, I., Merah, A., Quere, I., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Faul, J., Braester, A., Brenner, B., Tzoran, I., Barillari, G., Ciammaichella, M., Dalla Valle, F., Di Micco, P., Duce, R., Maida, R., Pasca, S., Piovella, C., Poggio, R., Prandoni, P., Quintavalla, R., Rocci, A., Rota, L., Schenone, A., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Brinquinho, M., Gomes, D., Goncalves, F., Santos, M., Saraiva, M., Bosevski, M., Kovacevic, D., Alatri, A., Aujeski, D., Bounameaux, H., Calanca, L., and Caprini, J.
Subjects: Male, medicine.medical_specialty, Observational Study, Hemorrhage, Cohort Studies, Recurrence, Neoplasms, 80 and over, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Venous Thrombosis, business.industry, Anticoagulants, Cancer, Venous Thromboembolism, General Medicine, Middle Aged, medicine.disease, Thrombosis, Confidence interval, Surgery, Pulmonary embolism, Venous thrombosis, Female, Gastrointestinal Hemorrhage, Pulmonary Embolism, business, Venous thromboembolism, Research Article, Cohort study
Abstract: In cancer patients treated for venous thromboembolism (VTE), including deep-vein thrombosis (DVT) and pulmonary embolism (PE), analyzing mortality associated with recurrent VTE or major bleeding is needed to determine the optimal duration of anticoagulation. This was a cohort study using the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) Registry database to compare rates of fatal recurrent PE and fatal bleeding in cancer patients receiving anticoagulation for VTE. As of January 2013, 44,794 patients were enrolled in RIETE, of whom 7911 (18%) had active cancer. During the course of anticoagulant therapy (mean, 181 ± 210 days), 178 cancer patients (4.3%) developed recurrent PE (5.5 per 100 patient-years; 95% CI: 4.8–6.4), 194 (4.7%) had recurrent DVT (6.2 per 100 patient-years; 95% confidence interval [CI]: 5.3–7.1), and 367 (8.9%) bled (11.3 per 100 patient-years; 95% CI: 10.2–12.5). Of 4125 patients initially presenting with PE, 43 (1.0%) died of recurrent PE and 45 (1.1%) of bleeding; of 3786 patients with DVT, 19 (0.5%) died of PE, and 55 (1.3%) of bleeding. During the first 3 months of anticoagulation, there were 59 (1.4%) fatal PE recurrences and 77 (1.9%) fatal bleeds. Beyond the third month, there were 3 fatal PE recurrences and 23 fatal bleeds. In RIETE cancer patients, the rate of fatal recurrent PE or fatal bleeding was much higher within the first 3 months of anticoagulation therapy.
Published: 2015

16. Validation of a score for predicting fatal bleeding in patients receiving anticoagulation for venous thromboembolism

Author: José Antonio Nieto, Rosario, Solano, Natacha Trapero Iglesias, Nuria Ruiz Giménez, Carmen Fernández Capitán, Beatriz, Valero, Gregorio, Tiberio, Alessandra Bura Riviere, Manuel, Monreal, Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Papadakis, M, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Malý, R, Arcelus, Ji, Arroyo, M, Ballaz, A, Barrón, M, Barrón Andrés, B, Bascuñana, J, Bedate, P, Blanco Molina, A, Bueso, T, Casado, I, del Molino, F, del Toro, J, Falgá, C, Fernández Capitán, C, Fole, D, Gallego, P, García Bragado, F, Gavín, O, Gómez, V, González, J, González Bachs, E, Grau, E, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Hernández Huerta, S, Jara Palomares, L, Jaras, Mj, Jiménez, D, Lecumberri, R, Lobo, Jl, López Jiménez, L, López Sáez JB, Lorente, Ma, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Muñoz, Fj, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Paul, He, Pedrajas, Jm, Peris, Ml, Quezada, Ca, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Rosa, V, Ruiz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Tiberio, G, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vela, J, Vidal, G, Villalobos, A, Villalta, J, Hirmerova, J, Salgado, E, Sánchez, Gt, Bura Riviere, A, Farge Bancel, D, Mahe, I, Merah, A, Quere, I, Babalis, D, Tzinieris, I, Braester, A, Barillari, G, Ciammaichella, M, Duce, R, Maida, R, Pasca, S, Pesavento, R, Piovaccari, G, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Barbosa, Al, Gomes, D, Gonçalves, F, Santos, M, Saraiva, M, Alatri, A, Aujeski, D, Calanca, L, and Mazzolai, L.
Subjects: Male, medicine.medical_specialty, Databases, Factual, medicine.drug_class, Low molecular weight heparin, Hemorrhage, Fatal outcome, Cohort Studies, Predictive Value of Tests, Risk Factors, Thromboembolism, medicine, Humans, Survival rate, Aged, Aged, 80 and over, Framingham Risk Score, business.industry, Reproducibility of Results, Anticoagulants, Venous Thromboembolism, Odds ratio, Hematology, medicine.disease, Prognosis, Surgery, Pulmonary embolism, Survival Rate, Predictive value of tests, Cohort, Female, business, Cohort study
Abstract: SummaryBackgroundThe only available score to assess the risk for fatal bleeding in patients with venous thromboembolism (VTE) has not been validated yet.MethodsWe used the RIETE database to validate the risk-score for fatal bleeding within the first 3months of anticoagulation in a new cohort of patients recruited after the end of the former study. Accuracy was measured using the ROC curve analysis.ResultsAs of December 2011, 39,284 patients were recruited in RIETE. Of these, 15,206 had not been included in the former study, and were considered to validate the score. Within the first 3months of anticoagulation, 52 patients (0.34%; 95% CI: 0.27-0.45) died of bleeding. Patients with a risk score of 4 points had a rate of 1.44%. The c-statistic for fatal bleeding was 0.775 (95% CI 0.720-0.830). The score performed better for predicting gastrointestinal (c-statistic, 0.869; 95% CI: 0.810-0.928) than intracranial (c-statistic, 0.687; 95% CI: 0.568-0.806) fatal bleeding. The score value with highest combined sensitivity and specificity was 1.75. The risk for fatal bleeding was significantly increased (odds ratio: 7.6; 95% CI 3.7-16.2) above this cut-off value.ConclusionsThe accuracy of the score in this validation cohort was similar to the accuracy found in the index study. Interestingly, it performed better for predicting gastrointestinal than intracranial fatal bleeding.
Published: 2013
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17. Platelet count and outcome in patients with acute venous thromboembolism

Author: Di Micco, P., Ruiz Giménez, N., Nieto, J. A., Aujesky, D., del Molino, F., Valle, R., Barrón, M., Maestre, A., Monreal, M., Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Tzoran, I, Dr Abilio, R, Bosevski, M, Bounameaux, H, Malý, R, Andújar, V, Arcelus, Ji, Arroyo, M, Ballaz, A, Barrón, M, Barrón Andrés, B, Bascuñana, J, Bedate, P, Benítez, Jf, Blanco Molina, A, Boix, L, Bosco, J, Bueso, T, Casado, I, Chaves, E, Contra, A, de Ancos CL, de Miguel, J, del Molino, F, del Toro, J, Elías Hernández, T, Falgá, C, Farfán, A, Fernández Capitán, C, Fole, D, Font, C, Fuentes, Mi, Gallego, P, García Bragado, F, Gavín, O, Gómez, V, González, J, González Basch, E, González Nieto JA, Grau, E, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Hernández Huerta, S, Jara, L, Jaras, Mj, Jiménez, D, Lecumberri, R, Lobo, Jl, López Jiménez, L, López, L, Lorenzo, A, Luque, Jm, Macià, M, Madridano, O, Maestre, A, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Muñoz, Fj, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Paul, He, Pedrajas, Jm, Peris, Ml, Quezada, Ca, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Toda, M, Todolí, Ja, Tolosa, C, Trujillo, J, Valdés, M, Valero, B, Valle, R, Vela, J, Vidal, G, Vilar, C, Villalobos, A, Villalta, J, Zorrilla, V, Gadelha, T, Hirmerova, J, Miklosovà, M, Salgado, E, Bura Riviere, A, Farge Bancel, D, Mahe, I, Merah, A, Quere, I, Faul, J, Braester, A, Zeltser, D, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Cardoso, C, Santos, M, Saraiva, M, Aujeski, D, Mazzolai, L, and Caprini, J.
Subjects: Blood Platelets, Male, Risk, medicine.medical_specialty, Cell Count, Hemorrhage, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Platelet, In patient, Registries, 030212 general & internal medicine, Mortality, Aged, Aged, 80 and over, Thrombocytosis, business.industry, Incidence, Mortality rate, Venous Thromboembolism, Hematology, Odds ratio, Middle Aged, medicine.disease, Thrombocytopenia, Thrombosis, Confidence interval, Surgery, Pulmonary embolism, Treatment Outcome, Acute Disease, Female, business, Venous thromboembolism
Abstract: SummaryThe relationship between platelet count and outcome in patients with acute venous thromboembolism (VTE) has not been consistently explored. RIETE is an ongoing registry of consecutive patients with acute VTE. We categorised patients as having very low- (450,000/μl) platelet count at baseline, and compared their three-month outcome. As of October 2012, 43,078 patients had been enrolled in RIETE: 21,319 presenting with pulmonary embolism and 21,759 with deep-vein thrombosis. In all, 502 patients (1.2%) had very low-; 5,472 (13%) low-; 28,386 (66%) normal-; 7,157 (17%) high-; and 1,561 (3.6%) very high platelet count. During the three-month study period, the recurrence rate was: 2.8%, 2.2%, 1.8%, 2.1% and 2.2%, respectively; the rate of major bleeding: 5.8%, 2.6%, 1.7%, 2.3% and 4.6%, respectively; the rate of fatal bleeding: 2.0%, 0.9%, 0.3%, 0.5% and 1.2%, respectively; and the mortality rate: 29%, 11%, 6.5%, 8.8% and 14%, respectively. On multivariate analysis, patients with very low-, low-, high- or very high platelet count had an increased risk for major bleeding (odds ratio [OR]: 2.70, 95% confidence interval [CI]: 1.85–3.95; 1.43 [1.18–1.72]; 1.23 [1.03–1.47]; and 2.13 [1.65–2.75]) and fatal bleeding (OR: 3.70 [1.92–7.16], 2.10 [1.48–2.97], 1.29 [0.88–1.90] and 2.49 [1.49–4.15]) compared with those with normal count. In conclusion, we found a U-shaped relationship between platelet count and the three-month rate of major bleeding and fatal bleeding in patients with VTE.
Published: 2013

18. Thrombolytic therapy and outcome of patients with an acute symptomatic pulmonary embolism

Author: RIERA MESTRE, A., Jiménez, D., Muriel, A., Lobo, J. L., Moores, L., Yusen, R. D., Casado, I., Nauffal, D., Oribe, M., Monreal, M., Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Papadakis, M, Bounameaux, H, Bosevski, M, Arcelus, Ji, Arcos, P, Barrón, M, Blanco, A, Bosco, J, Campano, F, Casado, I, Casas, Jm, Cisneros, E, Chaves, E, Conget, F, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Ferreiro, M, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Guil, M, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, M, Jiménez Castro, D, Jiménez, S, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Mascareño, Mc, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Ogea, M, Otero, R, Pedrajas, Jm, Rabuñal, R, Riera Mestre, A, Rodríguez Dávila MA, Roldán, V, Román, M, Román, P, Rosa, V, Rubio, S, Ruiz, Md, Ruíz, J, Ruiz Gamietea, A, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, M, Tiberio, G, Tolodí, Ja, Tolosa, C, Torres, Mi, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valdés, R, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, I, Rivron Guillot, K, Zeltser, D, Barillari, A, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Farneti, L, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, and Bounameaux, H.
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Blood Pressure, Lower risk, Risk Assessment, Fibrinolytic Agents, Predictive Value of Tests, Risk Factors, Internal medicine, Odds Ratio, medicine, Humans, Thrombolytic Therapy, Registries, Israel, Propensity Score, Intensive care medicine, Aged, Retrospective Studies, Aged, 80 and over, Chi-Square Distribution, business.industry, Retrospective cohort study, Hematology, Thrombolysis, Odds ratio, Middle Aged, medicine.disease, Pulmonary embolism, Europe, Logistic Models, Treatment Outcome, Predictive value of tests, Acute Disease, Propensity score matching, Cardiology, Female, Pulmonary Embolism, business, Chi-squared distribution
Abstract: To cite this article: Riera-Mestre A, Jimenez D, Muriel A, Lobo JL, Moores L, Yusen RD, Casado I, Nauffal D, Oribe M, Monreal M, for the RIETE investigators. Thrombolytic therapy and outcome of patients with an acute symptomatic pulmonary embolism. J Thromb Haemost 2012; 10: 751-9. Summary. Background: While the primary therapy for most patients with a pulmonary embolism (PE) consists of antico- agulation, the efficacy of thrombolysis relative to standard therapy remains unclear. Methods: In this retrospective cohort study of 15 944 patients with an objectively confirmed symp- tomatic acute PE, identified from the multicenter, international, prospective, Registro Informatizado de la Enfermedad TromboEmbolica (RIETE registry), we aimed to assess the association between thrombolytic therapy and all-cause mor- tality during the first 3 months after the diagnosis of a PE. After creating two subgroups, stratified by systolic blood pressure (SBP) (< 100 mm Hg vs. other), we used propensity score- matching for a comparison of patients who received thrombol- ysis to those who did not in each subgroup. Results: Patients who received thrombolysis were younger, had fewer comorbid diseases and more signs of clinical severity compared with those who did not receive it. In the subgroup with systolic hypoten- sion, analysis of propensity score-matched pairs (n = 94 pairs) showed a non-statistically significant but clinically relevant lower risk of death for thrombolysis compared with no thrombolysis (odds ratio (OR) 0.72; 95% confidence interval (CI), 0.36-1.46; P = 0.37). In the normotensive subgroup, analysis of propensity score-matched pairs (n = 217 pairs) showed a statistically significant and clinically meaningful increased risk of death for thrombolysis compared with no thrombolysis (OR 2.32; 95% CI, 1.15-4.68; P = 0.018). When we imputed data for missing values for echocardiography and troponin tests in the group of normotensive patients, we no longer detected the increased risk of death associated with thrombolytic therapy. Conclusions: In normotensive patients with acute symptomatic PE, thrombolytic therapy is associated with a higher risk of death than no thrombolytic therapy. In hemodynamically unstable patients, thrombolytic therapy is possibly associated with a lower risk of death than no thrombolytic therapy. However, study design limitations do not imply a causal relationship between thrombolytics and outcome.
Published: 2012

19. Unsuspected pulmonary embolism in patients with cancer

Author: Silvia, Soler, Cristina, Delgado, Aitor, Ballaz, Elena, Cisneros, Radován, Malý, Dimitrios, Babalis, Manuel, Monréal, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Papadakis, M, Bosevski, M, Bounameaux, H, Malý, R, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barrón, M, Blanco Molina, A, Bosco, J, Chaves, E, Conget, F, Delgado, C, De Ancos, C, del Toro, J, Falgá, C, Farfán, A, Fernández Capitán, C, Gallego, P, García Bragado, F, Gómez del Olmo, V, Guijarro, J, Guillém, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Macia, M, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Ogea, Jl, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Ruiz Ribó MD, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Mahe, I, Babalis, D, Tzinieris, I, Barillari, A, Barillari, G, Ciammaichella, C, Dalla Valle, F, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tonello, D, Visonà, A, and Tomko, T.
Subjects: Male, medicine.medical_specialty, Colorectal cancer, Comorbidity, Risk Assessment, Prostate, Neoplasms, Internal medicine, Prevalence, medicine, Humans, In patient, Registries, business.industry, Incidence (epidemiology), Anticoagulants, Cancer, Hematology, Prognosis, medicine.disease, Pulmonary embolism, Europe, Natural history, Treatment Outcome, medicine.anatomical_structure, Female, Radiology, Pulmonary Embolism, business
Abstract: Background The natural history of unsuspected pulmonary embolism (PE) in patients with cancer has not been thoroughly studied. Methods We used the RIETE Registry data to compare the clinical characteristics, treatment strategies and outcome in cancer patients with unsuspected PE and in those presenting with symptomatic, acute PE. Results Up to December 2011, 78 cancer patients with unsuspected PE and 1,994 with symptomatic PE had been enrolled. Patients with unsuspected PE more likely had colorectal cancer than those with symptomatic PE (28% vs. 13%), and less likely had prostate (3.8% vs. 10%) or hematologic (1.3% vs. 6.4%) cancer, or prior venous thromboembolism (3.8% vs. 12%). While the patients were receiving anticoagulant therapy, the incidence of PE recurrences (0% vs. 1.9%) or major bleeding (2.6% vs. 4.8%) were similar. After completion of anticoagulation, recurrent PE developed in 2.6% vs. 1.4% of patients, and major bleeding in 0% vs. 0.4%, respectively. Conclusions Our findings suggest that the clinical characteristics and outcome in cancer patients with unsuspected PE are quite similar to those in patients with symptomatic PE.
Published: 2012

20. Long-term therapy with low-molecular-weight heparin in cancer patients with venous thromboembolism

Author: Marchena, P. J., Nieto, J. A., Guil, M., García Bragado, F., Rabuñal, R., Boccalon, H., Trujillo Santos, J., Monreal, M., Akcalde, M, Arcelus, Ji, Barba, R, Blanco, A, Barrón, M, Casado, I, Casas, Jm, Cisneros, E, del Campo R., Ce, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hermosa, Mj, Hernández, L, Hernández Huerta, D, Jiménez, M, Lobo, Jl, López, L, Lorenzo, A, Luque, Jm, Madridano, O, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Oribe, M, Pedrajas, Jm, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, V, Valle, R, Vidal, G, Villalta, J, Boccalon, H, Durant, C, Farge Bancel, D, Mahe, I, Rivron Guillot, K, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tiraferri, E, Visonà, A, and Bosevski, M.
Subjects: Male, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, Gastroenterology, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Neoplasms, Internal medicine, medicine, Humans, Registries, Aged, business.industry, Incidence (epidemiology), Venous Thromboembolism, Hematology, Odds ratio, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Confidence interval, Pulmonary embolism, Surgery, Venous thrombosis, Treatment Outcome, 030220 oncology & carcinogenesis, Propensity score matching, Female, Pulmonary Embolism, business, Algorithms
Abstract: SummaryLong-term therapy with low-molecular-weight heparin (LMWH) is the treatment of choice for cancer patients with venous thromboembolism (VTE). However, the ideal doses of LMWH have not been thoroughly studied. We used the RIETE Registry data to assess the influence of the daily LMWH dosage on outcome during the first three months after VTE. We used propensity score-matching to compare patients who received
Published: 2012

21. Clinical presentation and outcome of venous thromboembolism in COPD

Author: Bertoletti, L., Quenet, S., Mismetti, P., Hernandez, L., Martin Villasclaras, J. J., Tolosa, C., Valdes, M., Barron, M., Todoli, J. A., Monreal, M., Monreal, M, Pujol, I, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Etienne, S, Papadakis, M, Bosevski, M, Bounameaux, H, Alcalde, M, Arcelus, Ji, Arcos, Mp, Barrón, M, Blanco Molina, A, Bosco, J, Cámara, T, Calvo, M, Casado, I, Casas, Jm, Cisneros, E, Chaves, E, Conget, F, Delgado, C, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Ferreiro, M, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Guil, M, Guillém, N, Gutiérrez, J, Hermosa, Mj, Hernández, L, Hernández Huerta, D, Hernández Toboso, F, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Manzano, V, Marchena, Pj, Martín Villasclaras JJ, Monte, R, Morales, M, Muñoz, S, Nauffal, Md, Nieto, Ja, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Rabuñal, R, Riera Mestre, A, Rodríguez Dávila MA, Román, M, Román, P, Román Bernal, B, Rosa, V, Rubio, S, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Torres, Mi, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Mahe, I, Rivron Guillot, K, Zeltser, D, Barillari, A, Barillari, G, Ciammaichella, M, Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Zalunardo, B, and Righini, M.
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Vena Cava Filters, Pulmonary disease, Kaplan-Meier Estimate, Pulmonary Disease, Chronic Obstructive, Fibrinolytic Agents, Risk Factors, Internal medicine, Humans, Medicine, Registries, cardiovascular diseases, Risk factor, Aged, Aged, 80 and over, Venous Thrombosis, COPD, business.industry, Venous Thromboembolism, Middle Aged, Prognosis, medicine.disease, respiratory tract diseases, Surgery, Pulmonary embolism, Venous thrombosis, Treatment Outcome, Female, Risk of death, Presentation (obstetrics), Pulmonary Embolism, business, Venous thromboembolism
Abstract: Chronic obstructive pulmonary disease (COPD) is a moderate risk factor for venous thromboembolism (VTE), but neither the clinical presentation nor the outcome of VTE in COPD patients is well known. The clinical presentation of VTE, namely pulmonary embolism (PE) or deep venous thrombosis (DVT), and the outcome at 3 months (death, recurrent VTE or bleeding) were compared between 2,984 COPD patients and 25,936 non-COPD patients included in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry. This ongoing international, multi-centre registry includes patients with proven symptomatic PE or DVT. PE was the more frequent VTE presentation in COPD patients (n = 1,761, 59%). PE presentation was more significantly associated with COPD patients than non-COPD patients (OR 1.64, 95% CI 1.49-1.80). During the 3-month follow-up, mortality (10.8% versus 7.6%), minor bleeding (4.5% versus 2.3%) or first VTE recurrences as PE (1.5% versus 1.1%) were significantly higher in COPD patients than in non-COPD patients. PE was the most common cause of death. COPD patients presented more frequently with PE than DVT. It may explain the worse prognosis of COPD patients, with a higher risk of death, bleeding or VTE recurrences as PE compared with non-COPD patients. Further therapeutic options are needed.
Published: 2011

22. Thirty-day mortality rate in women with cancer and venous thromboembolism. Findings from the RIETE Registry

Author: Javier Trujillo Santos, José Manuel Casa, Ignacio, Casado, Ángel Luis Samperiz, Roberto, Quintavalla, Joan Carles Sahuquillo, Manuel, Monreal, Arcelus, Ji, Barba, R, Barrón, M, Blanco, A, Bosco, J, Casado, I, Casas, Jm, Cisneros, E, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hernández, L, Hernández Toboso, S, Jiménez, D, Jiménez Gil, M, Jordán, S, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ochoa, F, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Ponce de León, L, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Muñoz Torrero SJ, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valdés, R, Vidal, G, Villalta, J, Boccalon, H, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, I, Rivron Guillot, K, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla, Vf, Duce, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tiraferri, E, Visonà, A, Bosevski, M, and Bounameaux, H.
Subjects: Adult, medicine.medical_specialty, Hemorrhage, Neoplasms, Internal medicine, Pancreatic cancer, medicine, Carcinoma, Humans, Prospective Studies, Registries, Prospective cohort study, Aged, Aged, 80 and over, Gynecology, Lung, business.industry, Mortality rate, Anticoagulants, Cancer, Venous Thromboembolism, Hematology, Middle Aged, medicine.disease, Pulmonary embolism, Treatment Outcome, medicine.anatomical_structure, Female, Pulmonary Embolism, business, Ovarian cancer
Abstract: The influence of the site of cancer on outcome in cancer women with venous thromboembolism (VTE) is poorly understood. Reliable information on its influence might facilitate better use of prevention strategies. We assessed the 30-day outcome in all women with active cancer in the RIETE Registry, trying to identify if differences exist according to the tumor site. Up to May 2010, 2474 women with cancer and acute VTE had been enrolled. The most common sites were the breast (26%), colon (13%), uterus (9.3%), and haematologic (8.6%) cancers. During the 30-day study period, 329 (13%) patients died. Of them, 71 (2.9%) died of pulmonary embolism (PE), 22 (0.9%) died of bleeding. Fatal PE was more common in women with breast, colorectal, lung or pancreatic cancer (59% of the fatal PEs). Fatal bleeding was more frequent in women with colorectal, haematologic, ovarian cancer or carcinoma of unknown origin (55% of fatal bleedings).
Published: 2011

23. Influence of recent immobilization or surgery on mortality in cancer patients with venous thromboembolism

Author: Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Papadakis, M, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Malý, R, Adarraga, Md, Arcelus, Ji, Ballaz, A, Barrón, M, Barrón Andrés, B, Bascuñana, J, Blanco Molina, A, Bueso, T, Casado, I, Castejón, N, Conget, F, del Molino, F, del Toro, J, Falgá, C, Fernández Capitán, C, Font, L, Fuentes, Mi, Gallego, P, García Bragado, F, García Lorenzo MD, Gómez, V, González, J, González Bachs, E, Grau, E, Guil, M, Gutiérrez, J, Hernández, L, Hernández Huerta, S, Jaras, Mj, Jiménez, D, Lecumberri, R, Lobo, Jl, López Jiménez, L, López Montes, L, López Reyes, R, López Sáez JB, Lorente, Ma, Lorenzo, A, Luque, Jm, Madridano, O, Marchena, Pj, Martín, M, Nauffal, D, Nieto, Ja, Núñez, Mj, Ogea, Jl, Pedrajas, Jm, Peris, Ml, Porras, Ja, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Roncero, A, Rosa, V, Ruiz Giménez, N, Ruiz, J, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Suriñach, Jm, Tiberio, G, Tolosa, C, Trujillo Santos, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vela, J, Vidal, G, Villalta, J, Verhamme, P, Peerlinck, K, Gadelha, T, Ribeiro, R, Vassalo, J, Wells, P, Hirmerova, J, Kaletova, M, Tomko, T, Bura Riviere, A, Farge Bancel, D, Hij, A, Mahe, I, Merah, A, Babalis, D, Tzinieris, I, Braester, A, Zeltser, D, Amitrano, M, Barillari, G, Ciammaichella, M, Duce, R, Giorgi Pierfranceschi, M, Maida, R, Prandoni, P, Quintavalla, R, Rocci, A, Rota, L, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Sá Bastos, M, Sousa, Ms, Rei, R, Kovacevic, D, and Mazzolai, L.
Subjects: Male, medicine.medical_specialty, Multivariate analysis, Hemorrhage, Immobilization, Neoplasms, medicine, Humans, In patient, Registries, Aged, Aged, 80 and over, business.industry, Mortality rate, Anticoagulants, Cancer, Venous Thromboembolism, Hematology, Odds ratio, Middle Aged, medicine.disease, Pulmonary embolism, Surgery, Increased risk, Multivariate Analysis, Female, Pulmonary Embolism, business, Venous thromboembolism
Abstract: Background: The influence of recent immobilization or surgery on mortality in cancer patients with venous thromboembolism (VTE) has not been thoroughly studied. Methods: We used the RIETE Registry data to compare the 3-month mortality rate in cancer patients with VTE, with patients categorized according to the presence of recent immobilization, surgery or neither. The major outcomes were fatal pulmonary embolism (PE) and fatal bleeding within the first 3 months. Results: Of 6,746 patients with active cancer and acute VTE, 1,224 (18%) had recent immobilization, 1,055 (16%) recent surgery, and 4,467 (66%) had neither. The all-cause mortality was 23.4% (95% CI: 22.4-24.5), and the PE-related mortality: 2.5% (95% CI: 2.1-2.9). Four in every ten patients dying of PE had recent immobilization (37%) or surgery (5.4%). Only 28% of patients with immobilization had received prophylaxis, as compared with 67% of the surgical. Fatal PE was more common in patients with recent immobilization (5.0%; 95% CI: 3.9-6.3) than in those with surgery (0.8%; 95% CI: 0.4-1.6) or neither (2.2%; 95% CI: 1.8-2.6). On multivariate analysis, patients with immobilization were at an increased risk for fatal PE (odds ratio: 1.8; 95% CI: 1.2-2.5). Conclusions: One in every three cancer patients dying of PE had recent immobilization for ≥4 days. Many of these deaths could have been prevented with adequate thromboprophylaxis.
Published: 2014

24. Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry

Author: Laurent, Bertoletti, Sara, Quenet, Silvy, Laporte, Joan, Sahuquillo, Francisco, Conget, José, Pedrajas, Mar, Martin, Ignacio, Casado, Antonio Riera Mestre, Manuel, Monreal, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barba, R, Barrón, M, Barrón Andrés, B, Blanco Molina, A, Bosco, J, Chaves, E, Cañas, I, Casado, I, Contra, A, Conget, F, de Miguel, J, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Gavín, O, Gómez, V, González, J, Gracia, V, Guil, M, Guillem, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, Lecumberri, R, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Morán, Lp, Nauffal, Md, Nieto, Ja, Núñez, Mj, Mascareño, Mc, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Roldán, V, Rosa, V, Royo, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valle, R, Vela, J, Vida, G, Villalta, J, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Farge Bancel, D, Lamuraglia, M, Mahe, I, Merah, A, Quere, I, Babalis, D, Papadakis, M, Brenner, B, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, La Regina, M, Maida, R, Orlandini, F, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Tonello, D, Visonà, A, Zalunardo, B, Bosevski, M, Bounameaux, H, Malý, R, Hirmerova, J, Salgado, E., BMC, Ed., Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Service de Médecine Thérapeutique, CHU Saint-Etienne-Hôpital Nord - Saint Etienne, Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Saint Etienne, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine, Hospital Municipal de Badalona, Department of Pneumonology, Hospital Clínico Universitario Lozano Blesa, Hospital Clínico San Carlos, Hospital Universitario Infanta Sofía, Hospital Universitario Virgen de las Nieves, Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL)-Hospital Universitari de Bellvitge-Hospital Duran i Reynals, Hospital Universitari Germans Trias I Pujol, The RIETE Investigators, Universitat de Barcelona, [Bertoletti,L, Quenet,S, Laporte,S] Thrombosis Research Group, EA3065, University Saint-Etienne, Saint-Etienne, France. [Bertoletti,L, Laporte,S] CIE3, INSERM, Saint-Etienne, France. Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne, France. [Sahuquillo,JC] Department of Internal Medicine, Hospital Municipal de Badalona, Barcelona, Spain. [Conget,F] Department of Pneumonology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. [Pedrajas,JM] Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain. [Martin,M] Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain. [Casado,I] Department of Pneumonology, Hospital Universitario Virgen de las Nieves, Granada, Spain. [Riera-Mestre,A] Department of Internal Medicine, Hospital Univesitari de Bellvitge - IDIBELL, Barcelona, Spain. [Monreal,M] Department of Internal Medicine, Hospital Universitari Germans Trias I Pujol, Badalona, Spain., and Bayer Pharma AG for supporting this Registry. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain
Subjects: Male, Internationality, Diseases::Respiratory Tract Diseases::Lung Diseases::Pulmonary Embolism [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Comorbidity, 030204 cardiovascular system & hematology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [Medical Subject Headings], Prevalence, Tasa de Supervivencia, Registries, Young adult, Pneumology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Embòlia pulmonar, Aged, 80 and over, COPD, Venous Thromboembolism, Middle Aged, Prognosis, 3. Good health, Pulmonary embolism, Survival Rate, Embolia Pulmonar, Deep venous thrombosis, Female, Pneumologia, Venous thromboembolism, Cohort study, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings], Pronòstic mèdic, Análisis de Supervivencia, Check Tags::Male [Medical Subject Headings], Risk Assessment, 03 medical and health sciences, Young Adult, Internal medicine, Thromboembolism, medicine, Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [Medical Subject Headings], Humans, cardiovascular diseases, Chronic obstructive pulmonary diseases, Intensive care medicine, Survival rate, Tromboembolisme, Survival analysis, Aged, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate [Medical Subject Headings], Disciplines and Occupations::Social Sciences::Internationality [Medical Subject Headings], business.industry, Enfermedad Pulmonar Obstructiva Crónica, Research, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment [Medical Subject Headings], equipment and supplies, medicine.disease, Survival Analysis, respiratory tract diseases, Check Tags::Female [Medical Subject Headings], 030228 respiratory system, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Registries [Medical Subject Headings], Estudios de Cohortes, Diseases::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thromboembolism::Venous Thromboembolism [Medical Subject Headings], business, Medición de Riesgo
Abstract: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients. METHODS COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)). RESULTS Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7). CONCLUSIONS COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients. Yes
Published: 2013

25. Factors associated with elevated pulmonary arterial pressure levels on the echocardiographic assessment in patients with prior pulmonary embolism

Author: Remedios, Otero, Teresa, Elías, Luis, Jara, Javier Trujillo Santos, Laurent, Bertoletti, Dolores, Nauffal, Justo Ruiz Ruiz, Ángeles Blanco Molina, Manuel, Monreal, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barba, R, Barragán, Jm, Barrón, M, Barrón Andrés, B, Bascuñana, J, Blanco Molina, A, Boix, L, Bosco, J, Bueso, T, Campano, Fj, Cañas, I, Casado, I, Conget, F, Contra, A, Chaves, E, de Miguel, J, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Gómez, V, González, J, Gracia, V, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jara, L, Jaras, Mj, Jiménez, D, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Roldán, V, Román, P, Rodríguez, Em, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vidal, G, Villalobos, A, Villalta, J, Zamora, L, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Farge Bancel, D, Mahe, I, Quere, I, Papadakis, M, Braester, A, Brenner, B, Zeltser, D, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Venturelli, U, Visonà, A, Zalunardo, B, Bosevski, M, Alatri, A, Aujeski, D, Bounameaux, H, Mazzolai, L, Malý, R, Tomko, T, Salgado, E, Schellong, S, and Caprini, J.
Subjects: Male, medicine.medical_specialty, Hypertension, Pulmonary, Background factors, Pulmonary arterial pressure, Risk Factors, Internal medicine, medicine.artery, medicine, Humans, In patient, Arterial Pressure, Aged, business.industry, Hematology, medicine.disease, Prognosis, Pulmonary embolism, stomatognathic diseases, Lung disease, Echocardiography, Heart failure, Pulmonary artery, Cardiology, Chronic thromboembolic pulmonary hypertension, Female, business, Pulmonary Embolism
Abstract: Factors associated with the detection of raised systolic pulmonary artery pressure (sPAP) levels in patients with a prior episode of pulmonary embolism (PE) are not well known.We used the RIETE Registry database to identify factors associated with the finding of sPAP levels ≥50 mm Hg on trans-thoracic echocardiography, in 557 patients with a prior episode of acute, symptomatic PE.Sixty-two patients (11.1%; 95% CI: 8.72-14.1) had sPAP levels ≥50 mm Hg. These patients were more likely women, older, and more likely had chronic lung disease, heart failure, renal insufficiency or leg varicosities than those with PAP levels50mm Hg. During the index PE event, they more likely had recent immobility, and more likely presented with hypoxemia, increased sPAP levels, atrial fibrillation, or right bundle branch block. On multivariate analysis, women aged ≥70 years (hazard ratio [HR]: 2.0; 95% CI: 1.0-3.7), chronic heart or chronic lung disease (HR: 2.4; 95% CI: 1.3-4.4), atrial fibrillation at PE presentation (HR: 2.8; 95% CI: 1.3-6.1) or varicose veins (HR: 1.8; 95% CI: 1.0-3.3) were all associated with an increased risk to have raised sPAP levels. Chronic heart disease, varicose veins, and atrial fibrillation were independent predictors in women, while chronic heart disease, atrial fibrillation, a right bundle branch block or an S1Q3T3 pattern on the electrocardiogram were independent predictors in men.Women aged ≥70 years more likely had raised sPAP levels than men after a PE episode. Additional variables influencing this risk seem to differ according to gender.
Published: 2012

26. A clinical prognostic model for the identification of low-risk patients with acute symptomatic pulmonary embolism and active cancer

Author: den Exter PL, Gómez, V, Jiménez, D, Trujillo Santos, J, Muriel, A, Huisman, Mv, Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Papadakis, M, Bosevski, M, Bounameaux, H, Malý, R, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barrón, M, Barrón Andrés, B, Blanco Molina, A, Boix, L, Bosco, J, Bueso, T, Campano, F, Cañas, I, Casado, I, Conget, F, de Miguel, J, del Campo, R, Chaves, E, del Toro, J, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Gavín, O, González, J, Gracia, V, Guil, M, Guillem, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, S, Jiménez Gil, M, Lobo, Jl, Lecumberri, R, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Mejías, I, Montero, L, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Roldán, V, Rosa, V, Royo, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tirado, R, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valle, R, Vela, J, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Farge Bancel, D, Lamuraglia, M, Mahe, I, Quere, I, Babalis, D, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, La Regina, M, Maida, R, Orlandini, F, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rota, L, Schenone, A, Tonello, D, Visonà, A, Zalunardo, B, Alatri, A, Calanca, L, Mazzolai, L, Hirmerova, J, Tomko, T, Salgado, E., Bayer, and Sanofi España
Subjects: Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Clinical prediction rule, Critical Care and Intensive Care Medicine, Risk Assessment, Severity of Illness Index, Decision Support Techniques, Cohort Studies, Random Allocation, Risk Factors, Internal medicine, Neoplasms, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, Framingham Risk Score, business.industry, Age Factors, Cancer, Reproducibility of Results, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Surgery, Pulmonary embolism, Cohort, Multivariate Analysis, Female, Cardiology and Cardiovascular Medicine, Risk assessment, business, Pulmonary Embolism, Cohort study
Abstract: [Background] Physicians need a specific risk-stratification tool to facilitate safe and cost-effective approaches to the management of patients with cancer and acute pulmonary embolism (PE). The objective of this study was to develop a simple risk score for predicting 30-day mortality in patients with PE and cancer by using measures readily obtained at the time of PE diagnosis., [Methods] Investigators randomly allocated 1,556 consecutive patients with cancer and acute PE from the international multicenter Registro Informatizado de la Enfermedad TromboEmbólica to derivation (67%) and internal validation (33%) samples. The external validation cohort for this study consisted of 261 patients with cancer and acute PE. Investigators compared 30-day all-cause mortality and nonfatal adverse medical outcomes across the derivation and two validation samples., [Results] In the derivation sample, multivariable analyses produced the risk score, which contained six variables: age > 80 years, heart rate ≥ 110/min, systolic BP < 100 mm Hg, body weight < 60 kg, recent immobility, and presence of metastases. In the internal validation cohort (n = 508), the 22.2% of patients (113 of 508) classified as low risk by the prognostic model had a 30-day mortality of 4.4% (95% CI, 0.6%–8.2%) compared with 29.9% (95% CI, 25.4%–34.4%) in the high-risk group. In the external validation cohort, the 18% of patients (47 of 261) classified as low risk by the prognostic model had a 30-day mortality of 0%, compared with 19.6% (95% CI, 14.3%–25.0%) in the high-risk group., [Conclusions] The developed clinical prediction rule accurately identifies low-risk patients with cancer and acute PE., We are grateful to Sanofi Spain for supporting this registry with an unrestricted educational grant. We are also grateful to Bayer Pharma AG for supporting this registry. Bayer Pharma AG's support was limited to the part of RIETE outside Spain, which accounts for 15.53% of the total patients included in the RIETE Registry.
Published: 2012

27. Influence of recent immobilization and recent surgery on mortality in patients with pulmonary embolism

Author: Nauffal, D., Ballester, M., LOPEZ REYES, R., Jiménez, D., Otero, R., Quintavalla, R., Monreal, M., Arcelus, J, Arcos, M, Ballaz, A, Barba, R, Barrón Andrés, B, Blanco Molina, A, Bosco, J, Chaves, E, Campano, F, Cañas, I, Casado, I, Cisneros, E, Conget, F, Delgado, C, de Miguel, J, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, Garcıá Bragado, F, Gavín, O, Gómez, V, González, J, Gracia, V, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, Lecumberri, R, López Jiménez, L, Lorenzo, A, Luque, Jm, Macia, M, Madridano, O, Maestre, A, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Morán, Lp, Nauffal, Md, Nieto, Ja, Núnéz, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Roldán, V, Rosa, V, Royo, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, Al, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, V, Valdés, M, Valle, R, Vela, J, Vidal, G, Villalta, J, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Mahe, I, Quere, I, Babalis, D, Papadakis, M, Brenner, B, Barillari, G, Ciammaichella, M, Dimicco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Bosevski, M, Bounameaux, H, Malý, R, Tomko, T, Decousus, H, Prandoni, P, Di Micco, P, and Malý, R.
Subjects: Male, medicine.medical_specialty, Immobilization, Risk Factors, Cause of Death, Medicine, Humans, In patient, Cause of death, Aged, Aged, 80 and over, business.industry, Mortality rate, Hematology, Surgical procedures, Middle Aged, medicine.disease, Confidence interval, Pulmonary embolism, Surgery, Increased risk, Surgical Procedures, Operative, Female, business, Pulmonary Embolism, Surgical patients
Abstract: Summary. Background: The influence of recent immobilization or surgery on mortality in patients with pulmonary embolism (PE) is not well known. Methods: We used the Registro Informatizado de Enfermedad TromboEmbolica (RIETE) data to compare the 3-month mortality rate in patients with PE, with patients categorized according to the presence of recent immobilization, recent surgery, or neither. Results: Of 18 028 patients with PE, 4169 (23%) had recent immobilization, 2212 (12%) had recent surgery, and 11 647 (65%) had neither. The all-cause mortality was 10.0% (95% confidence interval [CI] 9.5–10.4), and the PE-related mortality was 2.6% (95% CI 2.4–2.9). One in every two patients who died from PE had recent immobilization (43%) or recent surgery (6.7%). Only 25% of patients with immobilization had received prophylaxis, as compared with 65% of the surgical patients. Fatal PE was more common in patients with recent immobilization (4.9%; 95% CI 4.3–5.6) than in those with surgery (1.4%; 95% CI 1.0–2.0) or those with neither (2.1%; 95% CI 1.8–2.3). On multivariate analysis, patients with immobilization were at increased risk for fatal PE (odds ratio 2.2; 95% CI 1.8–2.7), with no differences being seen between patients immobilized in hospital or in the community. Conclusions: Forty-three per cent of patients dying from PE had recent immobilization for ≥ 4 days. Many of these deaths could have been prevented.
Published: 2012

28. Low-molecular-weight or unfractionated heparin in venous thromboembolism: the influence of renal function

Author: Javier Trujillo Santos, Sebastian, Schellong, Conxita, Falga, Vanessa, Zorrilla, Pedro, Gallego, Manuel, Barrón, Manuel, Monreal, Arcelus, Ji, Ballaz, A, Barba, R, Barragán, Jm, Barrón, M, Barrón Andrés, B, Bascuñana, J, Blanco Molina, A, Bosco, J, Cañas, I, Casado, I, Conget, F, Chaves, E, de Miguel, J, del Campo, R, del Molino, F, del Toro, J, Falgá, C, Fernández, M, Fernández Capitán, C, Fuentes, L, Gabriel, F, Gallego, P, García Bragado, F, Gómez, V, González, J, Guil, M, Gutiérrez, J, Hernández, L, Hernández, Hd, Jaras, Mj, Jiménez, D, Jiménez, S, Lobo, Jl, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Román, P, Rodríguez, Em, Román Bernal, B, Royo, C, Ruiz Martínez, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valle, R, Vela, J, Vidal, G, Villalta, J, Zorrilla, V, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Orlandini, F, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Zalunardo, B, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Farge Bancel, D, Lamuraglia, M, Mahe, I, Quere, I, Brenner, B, Alatri, A, Bounameaux, H, Calanca, L, Mazzolai, L, Malý, R, Hirmerova, J, Tomko, T, Schellong, S, Papadakis, M, Bosevski, M, Salgado, E, La Regina, M, and Rodríguez Dávila MA
Subjects: Adult, Male, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Renal function, Kidney, Kidney Function Tests, Gastroenterology, Internal medicine, medicine, Humans, Renal Insufficiency, Intensive care medicine, Aged, business.industry, Heparin, General Medicine, Odds ratio, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Confidence interval, Pulmonary embolism, Treatment Outcome, Propensity score matching, Female, business, Venous thromboembolism, medicine.drug, Follow-Up Studies
Abstract: In patients with acute venous thromboembolism and renal insufficiency, initial therapy with unfractionated heparin may have some advantages over low-molecular-weight heparin.We used the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) Registry data to evaluate the 15-day outcome in 38,531 recruited patients. We used propensity score matching to compare patients treated with unfractionated heparin with those treated with low-molecular-weight heparin in 3 groups stratified by creatinine clearance levels at baseline:60 mL/min, 30 to 60 mL/min, or30 mL/min.Patients initially receiving unfractionated heparin therapy (n = 2167) more likely had underlying diseases than those receiving low-molecular-weight heparin (n = 34,665). Propensity score-matched groups of patients with creatinine clearance levels60 mL/min (n = 1598 matched pairs), 30 to 60 mL/min (n = 277 matched pairs), and30 mL/min (n = 210 matched pairs) showed an increased 15-day mortality for unfractionated heparin compared with low-molecular-weight heparin (4.5% vs 2.4% [P = .001], 5.4% vs 5.8% [P = not significant], and 15% vs 8.1% [P = .02], respectively), an increased rate of fatal pulmonary embolism (2.8% vs 1.2% [P = .001], 3.2% vs 2.5% [P = not significant], and 5.7% vs 2.4% [P = .02], respectively), and a similar rate of fatal bleeding (0.3% vs 0.3%, 0.7% vs 0.7%, and 0.5% vs 0.0%, respectively). Multivariate analysis confirmed that patients treated with unfractionated heparin were at increased risk for all-cause death (odds ratio, 1.8; 95% confidence interval, 1.3-2.4) and fatal pulmonary embolism (odds ratio, 2.3; 95% confidence interval, 1.5-3.6).In comparison with low-molecular-weight heparin, initial therapy with unfractionated heparin was associated with a higher mortality and higher rate of fatal pulmonary embolism in patients with creatinine clearance levels60 mL/min or30 mL/min, but not in those with levels between 30 and 60 mL/min.
Published: 2012

29. Silent pulmonary embolism in patients with proximal deep vein thrombosis in the lower limbs

Author: Tzoran, I., Saharov, G., Brenner, B., Delsart, D., Román, P., Visoná, A., Jiménez, D., Monreal, M., Arcelus, Ji, Arcos, Mp, Ballaz, A, Barba, R, Barrón, M, Blanco Molina, A, Bosco, J, Chaves, E, Conget, F, Delgado, C, De Ancos, C, del Toro, J, Falgá, C, Farfán, A, Fernández Capitán, C, Gallego, P, García Bragado, F, Gómez del Olmo, V, Guijarro, J, Guillém, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Macia, M, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Ogea, Jl, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Ruiz Ribó MD, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Mahe, I, Papadakis, M, Babalis, D, Tzinieris, I, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tonello, D, Visonà, A, Bosevski, M, Bounameaux, H, Malý, R, and Tomko, T.
Subjects: Male, medicine.medical_specialty, Time Factors, Deep vein, Hemorrhage, Risk Assessment, Risk Factors, medicine, Odds Ratio, Humans, Clinical significance, Prospective Studies, Registries, Israel, Prospective cohort study, Aged, Aged, 80 and over, Venous Thrombosis, Chi-Square Distribution, business.industry, Incidence (epidemiology), Incidence, Anticoagulants, Hematology, Odds ratio, Middle Aged, medicine.disease, Thrombosis, Survival Analysis, Surgery, Pulmonary embolism, Europe, medicine.anatomical_structure, Logistic Models, Treatment Outcome, Lower Extremity, Asymptomatic Diseases, Multivariate Analysis, Female, business, Pulmonary Embolism, Chi-squared distribution
Abstract: Summary. Background: One in every three patients with deep vein thrombosis (DVT) in the lower limbs may have silent pulmonary embolism (PE), but its clinical relevance has not been thoroughly studied. Methods: We used the RIETE Registry data to study patients with proximal DVT and no PE symptoms, but with a systematic search for PE. We compared the outcome of DVT patients with silent PE and those with no PE. Results: Of 2375 patients with DVT, 842 (35%) had silent PE and 1533 had no PE. During the first 15 days of anticoagulation, patients presenting with silent PE had a higher incidence of symptomatic PE events than those with no PE (0.95% vs. 0.13%; P = 0.015), with a similar incidence of major bleeding (0.95% vs. 1.63%; P = 0.09). In patients with silent PE, the incidence of PE events during the first 15 days was equal to the incidence of major bleeding (eight events each), but in those with no PE the incidence of PE events was eight times lower (3 vs. 25 bleeding events). Multivariate analysis confirmed that DVT patients with silent PE had a higher incidence of symptomatic PE events during the first 15 days than those with no PE (odds ratio, 4.80; 95% CI, 1.27–18.1), with no differences in bleeding. Conclusions: DVT patients with silent PE at baseline had an increased incidence of symptomatic PE events during the first 15 days of anticoagulant therapy. This effect disappeared after 3 months of anticoagulation.
Published: 2012

30. Oral Rivaroxaban for the Treatment of Symptomatic Pulmonary Embolism

Author: Agnelli, G, Berkowitz, S, Bounameaux, H, Büller, Hr, Cohen, A, Gallus, A, Lensing, Aw, Misselwitz, F, Haskell, L, Prins, Mh, Raskob, G, Schellong, S, Bauersachs, R, van Bellen, B, Boda, Z, Borris, L, Brenner, B, Brighton, T, Chlumsky, J, Davidson, B, Decousus, H, Eriksson, H, Jacobson, B, Kakkar, A, Kwong, Yl, Lee, Lh, Meijer, K, van der Meer, J, Minar, E, Monreal, M, Piovella, F, Sandset, Pm, Smith, M, Tomkowski, W, Verhamme, P, Wang, Y, Wells, P, Brandjes, D, Mac Gillavry, M, Otten, Hm, Carlsson, A, Laporte, S, Schulman, S, Gent, M, Turpie, A, Martinelli, I, Segers, A, Muhlhofer, E, Tewes, M, Trajanovic, M, Muller, K, Kim, C, Gebel, M, Benson, A, Pap, Af, Godrie, J, Horvat Broecker, A, Spadari, G, Peters Wulf, C, Roig, J, Baker, R, Bianchi, A, Blombery, P, Campbell, P, Carroll, P, Geraghty, R, Chong, B, Ramanathan, S, Archis, C, Coughlin, P, Salem, H, Crispin, P, Dean, M, Soni, R, Denaro, C, Kubler, P, Coghlan, D, Gan, Te, Tran, H, Coleman, C, Jackson, D, Khalafallah, A, Leahy, M, Leyden, M, Leyden, D, Sturtz, C, Mccann, A, Gibbs, H, Mcrae, S, Richards, B, Ward, C, Curnow, J, Baghestanian, M, Erdogmus, B, Samaha, E, Nikoupayan Mofrad, M, Hirschl, M, Sturm, W, Kirchmair, R, Marschang, P, Drexel, H, Mathies, R, Pilger, E, Brodmann, M, Weltermann, A, Buche, M, Demelenne, J, Gustin, M, Hainaut, P, Pothen, L, de Leersnyder, J, Motte, S, Schroë, H, Sprynger, M, Peerlinck, K, Delcroix, M, Vermassen, F, Verstraeten, P, Smet, V, Vossaert, R, Panico, M, Costa, C, Blondal, J, Kovacs, M, Rodger, M, Carrier, M, Wong, T, Bi, J, Chen, Z, Chen, R, Jing, Zc, He, J, Liu, C, Liu, S, Long, S, Ma, Y, Shao, Y, Wang, C, Yang, Yh, Xie, C, Xu, J, Ying, K, Zhihong, L, Hola, D, Jirat, S, Vitovec, M, Kovářová, K, Gilík, J, Dosál, J, Mandakova, E, Matoška, P, Podpera, I, Podperova, M, Spacek, R, Urbanova, R, Tuxen, C, Sukles, K, Pietila, K, Vesanen, M, Achkar, A, Agraou, B, Aquilanti, S, Rifaï, A, Berremili, T, Brisot, D, Brousse, C, Tarodo, P, Bura, A, Amid Lacombe, C, Malloizel, J, Boulon, C, Alavoine, L, Crestani, B, Mismetti, P, Buchmuller, A, Accassat, S, Elias, A, Elias, M, Emmerich, J, Ferrari, E, Guérin, T, Beaka, P, Lacroix, P, Szwebel, Ta, Benhamou, Y, de Maistre, E, Falvo, N, Mahe, I, Meneveau, N, Schiele, F, Meyer, G, Sanchez, O, Planquette, B, Mottier, D, Le Moigne, E, Couturaud, F, Parent, F, Pernod, G, Imbert, B, Elkouri, D, Dary, M, Queguiner, A, Quere, I, Galanaud, Jp, Roy, Pm, de Boisjolly Bonnefoi JM, Schmidt, J, Breuil, N, Heuser, S, Sevestre, Ma, Simoneau, G, Bergmann, Jf, Stephan, D, Trinh Duc, A, Gaillardou, A, Grange, C, Fassier, T, Wahl, D, Baron Von Bilderling, P, Kuhlencordt, P, Beyer Westendorf, J, Halbritter, K, Werth, S, Diehm, C, Lawall, H, Eifrig, B, Espinola Klein, C, Weisser, G, Giannitsis, E, Haering, Hu, Hasslacher, C, Herrmann, T, Hoffmann, U, Czihal, M, Horacek, T, Ibe, M, Bauer, A, Kieback, A, Landgraf, H, Lindhoff Last, E, Malyar, N, Petermann, W, Potratz, J, Ranft, J, Röcken, M, Pomper, L, Frommhold, R, Schwaiblmair, M, Berghaus, T, Taute, B, Lau, Yk, Tse, E, Olah, Z, Farkas, K, Kolossváry, E, Gurzó, M, Kis, E, Kovács, A, Landi, A, Lupkovics, G, Pecsvarady, Z, Riba, M, Sipos, G, Parakh, R, Sembiring, R, Barton, J, Goldstein, L, Gavish, D, Hoffman, R, Hussein, O, Inbal, A, Lishner, M, Elis, A, Lugassy, G, Varon, D, Zeltser, D, Rogowski, O, Steinvil, A, Zisman, D, Ageno, W, Ambrosio, G, Cattaneo, M, D'Angelo, A, Ghirarduzzi, A, Lotti, M, Pierfranceschi, Mg, Lodigiani, C, Palareti, G, Barone, M, Beltrametti, C, Porreca, E, Prandoni, Paolo, Spiezia, L, Quintavalla, R, Cho, Wh, Ha, Jw, Kim, Hs, Park, K, Sime, I, Miliauskas, S, Petrauskiene, R, Sathar, J, Beeker, A, Ten Cate, H, De Groot, M, Kamphuisen, P, Douma, R, Kooy, Mv, Coenen, J, Mäkelburg, A, Knol, M, Tichelaar, V, Harper, P, Knottenbelt, E, Ockelford, P, Young, L, Royle, G, Simpson, D, Chunilal, S, Ghanima, W, Foyn, S, Tveit, A, Abola, Mt, Adamiec, R, Gorski, P, Kloczko, J, Lewczuk, J, Nowak, M, Musial, J, Wronski, J, Ng, Hj, Adler, D, Becker, Jh, Ellis, G, Isaacs, R, Bloy, B, Allie, R, Eckstein, F, van Rensburg JH, Schmidt, S, Siebert, H, Zyl, L, Carrera, M, Del Campo, F, Diego, I, Garcia Bragado, F, Jiménez, D, Sánchez Álvarez, J, Redondo, M, Roman Sanchez, P, Villalta, J, Villegas Scivetti, M, Jonson, T, Tygesen, H, Lapidus, L, Ottosson, E, Själander, A, Asmis, L, Banyai, M, Heidemann, M, Baumgartner, I, Righini, M, Frank, U, Hayoz, D, Periard, D, Chang, Wt, Chiu, K, Wang, Ky, Weng, Zc, Angchaisuksiri, P, Pothirat, C, Rojnuckarin, P, Solis, J, Hunt, B, Luckit, J, Albrecht, C, Banish, D, Feinbloom, D, Botnick, W, Chen, D, Dexter, J, Ettinger, N, Gleeson, J, Jaffer, A, Joseph, S, Kennedy, M, Krell, K, Lavender, R, Lyons, R, Moll, S, Nadar, V, Darrow, K, Hardman, V, Rathbun, S, Rehm, J, Rodriguez Cintron, W, Stevens, K, Wright, P, Ramaswamy, M., ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, Other departments, Epidemiologie, MUMC+: KIO Kemta (9), RS: CAPHRI School for Public Health and Primary Care, Department of Vascular Medicine (DVM - AMC), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA)-University of Amsterdam [Amsterdam] (UvA), Department of Epidemiology (MHP), Maastricht University [Maastricht], Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Pulmonary Embolism, Male, Vitamin K, Administration, Oral, Pulmonary Embolism/drug therapy/mortality, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, chemistry.chemical_compound, 0302 clinical medicine, Rivaroxaban, Edoxaban, Recurrence, Hemorrhage/chemically induced, 030212 general & internal medicine, Vitamin K/antagonists & inhibitors, Enoxaparin/adverse effects/therapeutic use, MESH: Treatment Outcome, MESH: Aged, ddc:616, MESH: Middle Aged, Hazard ratio, General Medicine, MESH: Follow-Up Studies, Vitamin K antagonist, MESH: Thiophenes, Middle Aged, Thrombosis, Morpholines/adverse effects/therapeutic use, 3. Good health, Pulmonary embolism, MESH: International Normalized Ratio, Treatment Outcome, Anesthesia, MESH: Administration, Oral, Administration, Combination, Apixaban, Drug Therapy, Combination, Female, MESH: Hemorrhage, medicine.drug, Oral, MESH: Enoxaparin, medicine.drug_class, Morpholines, Anticoagulants/adverse effects/therapeutic use, MESH: Morpholines, Hemorrhage, Thiophenes, MESH: Anticoagulants, 03 medical and health sciences, Drug Therapy, medicine, Humans, International Normalized Ratio, Enoxaparin, MESH: Kaplan-Meier Estimate, Aged, MESH: Humans, business.industry, MESH: Vitamin K, Anticoagulants, medicine.disease, MESH: Male, MESH: Recurrence, Regimen, MESH: Drug Therapy, Combination, chemistry, Thiophenes/adverse effects/therapeutic use, business, Pulmonary Embolism, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; BACKGROUND: A fixed-dose regimen of rivaroxaban, an oral factor Xa inhibitor, has been shown to be as effective as standard anticoagulant therapy for the treatment of deep-vein thrombosis, without the need for laboratory monitoring. This approach may also simplify the treatment of pulmonary embolism. METHODS: In a randomized, open-label, event-driven, noninferiority trial involving 4832 patients who had acute symptomatic pulmonary embolism with or without deep-vein thrombosis, we compared rivaroxaban (15 mg twice daily for 3 weeks, followed by 20 mg once daily) with standard therapy with enoxaparin followed by an adjusted-dose vitamin K antagonist for 3, 6, or 12 months. The primary efficacy outcome was symptomatic recurrent venous thromboembolism. The principal safety outcome was major or clinically relevant nonmajor bleeding. RESULTS: Rivaroxaban was noninferior to standard therapy (noninferiority margin, 2.0; P=0.003) for the primary efficacy outcome, with 50 events in the rivaroxaban group (2.1%) versus 44 events in the standard-therapy group (1.8%) (hazard ratio, 1.12; 95% confidence interval [CI], 0.75 to 1.68). The principal safety outcome occurred in 10.3% of patients in the rivaroxaban group and 11.4% of those in the standard-therapy group (hazard ratio, 0.90; 95% CI, 0.76 to 1.07; P=0.23). Major bleeding was observed in 26 patients (1.1%) in the rivaroxaban group and 52 patients (2.2%) in the standard-therapy group (hazard ratio, 0.49; 95% CI, 0.31 to 0.79; P=0.003). Rates of other adverse events were similar in the two groups. CONCLUSIONS: A fixed-dose regimen of rivaroxaban alone was noninferior to standard therapy for the initial and long-term treatment of pulmonary embolism and had a potentially improved benefit-risk profile. (Funded by Bayer HealthCare and Janssen Pharmaceuticals; EINSTEIN-PE ClinicalTrials.gov number, NCT00439777.).
Published: 2012

31. Effects of age on the risk of dying from pulmonary embolism or bleeding during treatment of deep vein thrombosis

Author: Juan Francisco Sanchez Muñoz Torrero, Henri, Bounameaux, José María Pedrajas, Alicia, Lorenzo, Silvino, Rubio, Clive, Kearon, Luís, Hernández, Manuel, Monreal, Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Rivron Guillot, K, Arcelus, Ji, Blanco, A, Barrón, M, Casado, I, Casas, Jm, Cisneros, E, del Campo, R, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Gómez Zorilla, S, Guijarro, R, Guil, M, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jiménez, D, Jiménez, M, Jordán, S, Lecumberri, R, Lobo, Jl, López, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Nauffal, Md, Nieto, Ja, Núñez, Mj, Oribe, M, Otero, R, Pedrajas, Jm, Rabuñal, R, Riera Mestre, A, Román, P, Rosa, V, Rubio, S, Ruíz, Fj, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Sánchez, R, Soler, S, Soler, C, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, V, Valle, R, Vela, J, Vidal, G, Villalta, J, Boccalon, H, Delluc, A, Farge Bancel, D, Mahe, I, Barillari, A, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Piovella, C, Poggio, R, Prandoni, P, Pasca, S, Quintavalla, R, Schenone, A, Tiraferri, E, Visonà, A, Bosevski, M, Bounameaux, H., Servicio de Medicina Interna (SMI - Cacerès), Hospital San Pedro de Alcantara, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Servicio de Medicina Interna (SMI - Madrid), Hospital Clínico San Carlos, Servicio de Medicina Interna (SMI - La Paz - Madrid), Hospital Universitario La Paz, Servicio de Medicina Interna (SMI - Gijon), Hospital de Cabueñes, Department of Medicine (DM - McMaster), McMaster University [Hamilton, Ontario], Servicio de Medicina Interna (SMI), Hopital Universitario Germans Trias i Pujol, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)
Subjects: Male, MESH: Pulmonary Embolism, Deep vein, 030204 cardiovascular system & hematology, MESH: Risk Assessment, 0302 clinical medicine, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, 030212 general & internal medicine, 10. No inequality, Venous Thrombosis, ddc:616, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Middle Aged, Thrombosis, Hemorrhage/chemically induced/mortality, 3. Good health, Pulmonary embolism, medicine.anatomical_structure, Female, Risk assessment, Cardiology and Cardiovascular Medicine, MESH: Hemorrhage, Adult, medicine.medical_specialty, Anticoagulants/adverse effects/therapeutic use, Hemorrhage, MESH: Anticoagulants, Risk Assessment, 03 medical and health sciences, Patient age, medicine, Humans, In patient, cardiovascular diseases, Pulmonary Embolism/mortality/prevention & control, Aged, MESH: Humans, business.industry, Anticoagulants, MESH: Adult, Odds ratio, medicine.disease, Confidence interval, MESH: Male, Surgery, MESH: Venous Thrombosis, Pulmonary Embolism, business, Venous Thrombosis/drug therapy, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND: The risk of patients dying of pulmonary embolism (PE) or bleeding during the treatment of deep vein thrombosis (DVT), and whether these risks are influenced by patient age, has not been thoroughly studied. METHODS: We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to assess the risk of fatal PE and fatal bleeding in 16,199 patients with lower limb DVT (without symptomatic PE at the time of inclusion) during the 3 months after diagnosis, with patients categorized according to age. RESULTS: During the 3 months of anticoagulant treatment, there were 31 fatal PEs (0.19%) and 83 fatal hemorrhages (0.51%). During the first 7 days of therapy, the frequency of fatal PEs was similar to that of fatal bleeding (12 vs 14 deaths, respectively; odds ratio [OR], 0.86; 95% confidence interval [CI], 0.39-1.87). However, from days 8 to 90, the frequency of fatal bleeding was greater than that of fatal PE (69 vs 19 deaths; OR, 3.64; 95% CI, 2.22-6.20). The higher frequency of fatal bleeding compared with fatal PE from days 8 to 90 appeared to be confined to patients who were aged ≥ 60 years. Multivariate analysis showed that patient age was independently associated with an increased risk of death from bleeding during the first 3 months: every 10 years the OR increased by 1.37 (95% CI, 1.12-1.67). CONCLUSIONS: During the first week of treatment, the risk of fatal bleeding and fatal PE were similar. Then, particularly in patients who were aged ≥ 60 years, the risk of dying from bleeding exceeded the risk of dying from PE.
Published: 2011

32. Venous thromboembolism in patients with intracranial haemorrhage

Author: Lobo, J. L., Nieto, J. A., Zorrilla, V., Garrido, N., Madridano, O., Ruiz, J., Farge Bancel, D., Tiberio, G., Uresandi, F., Monreal, M., Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Rivron Guillot, K, Bosevski, M, Arcelus, Ji, Barrón, M, Blanco, A, Bosco, J, Casado, I, Casas, Jm, Cisneros, E, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, González, Jp, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hernández, L, Hernández Huerta, D, Hernández Toboso, S, Jiménez, D, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Montaña, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Provenza, M, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruíz, C, Ruíz, J, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez, Mt, Soler, S, Soto, Mj, Tiberio, G, Timiraos, J, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Boccalon, H, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, I, Mismetti, P, Szwebel, T, Barillari, G, Ciammaichella, Bb, Ciammaichella, M, Dalla, Vf, Duce, R, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, and Bosevski, M.
Subjects: Male, Risk, 0301 basic medicine, medicine.medical_specialty, Intracranial haemorrhage, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Drug Dosage Calculations, In patient, Aged, business.industry, General surgery, Vascular biology, Anticoagulants, Hematology, Heparin, Low-Molecular-Weight, Middle Aged, Survival Analysis, Surgery, 030104 developmental biology, Spain, Female, Pulmonary Embolism, business, Intracranial Hemorrhages, Venous thromboembolism, Follow-Up Studies, Pneumonology
Abstract: Jose Luis Lobo1; Jose Antonio Nieto2; Vanesa Zorrilla1; Noelia Garrido2; Olga Madridano3; Justo Ruiz4; Dominique Farge-Bancel5; Gregorio Tiberio6; Fernando Uresandi7; Manuel Monreal8; the RIETE Investigators* 1Department of Pneumonology, Hospital de Txagorritxu, Vitoria, Spain; 2Department of Internal Medicine, Hospital Virgen de la Luz, Cuenca, Spain; 3Department of Internal Medicine, Hospital Infanta Sofia, Madrid, Spain; 4Department of Internal Medicine, Hospital de Fuenlabrada, Madrid, Spain; 5Department of Internal Medicine, Hopital SaintLouis, Paris, France; 6Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Navarra, Spain; 7Department of Pneumonology, Hospital de Cruces, Barakaldo, Vizcaya, Spain; 8Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
Published: 2011

33. Natural history of patients developing thrombocytopenia while receiving anticoagulant therapy for venous thromboembolism

Author: Di Micco, P, Fontanella, A, Falvo, N, Bonithon Kopp, C, Decousus, H, Riera Mestre, A, Monreal, M, Prandoni, Paolo, Brenner, B, Barba, R, Rivron Guillot, K, Bosevski, M, Alcalde, M, Arcelus, Ji, Barrón, M, Blanco, A, Boix, L, Bosco, J, Bruscas, Mj, Casado, I, Casas, Jm, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hermosa, Mj, Hernández, L, Hernández Juerta, D, Jiménez, M, Jordán, S, Lecumberri, R, Lobo, Jl, López, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Rabuñal, R, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Villalta, J, Boccalon, H, Farge Bancel, D, Mahe, I, Szwebel, Ta, Barillari, A, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Marconi, M, Pasca, S, Piovaccari, Gc, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Zalunardo, B, and Bosevski, M.
Subjects: Aged, 80 and over, Male, Time Factors, Platelet Count, Anticoagulants, Hemorrhage, Venous Thromboembolism, Middle Aged, Risk Assessment, Thrombocytopenia, Europe, Risk Factors, Disease Progression, Secondary Prevention, Humans, Female, Registries, Aged, Retrospective Studies

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

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

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

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

36. Timing and characteristics of venous thromboembolism after noncancer surgery

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

37. Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism

Author: Weitz, Jeffrey I., Lensing, Anthonie W.A., Prins, Martin H., Bauersachs, Rupert, Beyer-Westendorf, Jan, Bounameaux, Henri, Brighton, Timothy A., Cohen, Alexander T., Davidson, Bruce L., Decousus, Hervé, Freitas, Maria C.S., Holberg, Gerlind, Kakkar, Ajay K., Haskell, Lloyd, Van Bellen, Bonno, Pap, Akos F., Berkowitz, Scott D., Verhamme, Peter, Wells, Philip S., Prandoni, Paolo, Riera Mestre, Antoni, EINSTEIN CHOICE Investigators, McMaster University [Hamilton, Ontario], Klinikum Darmstadt (RMB), Klinikum Darmstadt, Carl Gustav Carus University (DRESDEN - CGCU), Technische Universität Dresden = Dresden University of Technology (TU Dresden), Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, King's College Hospital (KCH), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), University of Ottawa [Ottawa], Thromboembolism Unit (PP), Universita degli Studi di Padova, 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), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, MUMC+: KIO Kemta (9), RS: CAPHRI - R5 - Optimising Patient Care, Epidemiologie, Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), EINSTEIN CHOICE Investigators, Bianchi, A., Brighton, T., Carroll, P., Chong, B., Chunilal, S., Coughlin, P., Curnow, J., Jackson, D., Tran, H., Ward, C., Brodmann, M., Kyrle, P., Marschang, P., Petkov, V., Hainaut, P., Jordens, P., Vandekerkhof, J., Verhamme, P., Wautrecht, J-C, Annichino-Bizzacchi, J., van Bellen, B., Correa, J., Cukier, A., Freire, A., Pereira, A., Porto, C., Sacilotto, R., Vasconcelos Costa, A., Della Siega, A., Dolan, S., Le Gal, G., Gross, P., Kahn, S., Kassis, J., Kovacs, M., Pesant, Y., Ritchie, B., Schulman, S., Shivakumar, S., Solymoss, S., Chang, S., Chen, R., Chen, Z., Chen, H., Dai, X., Fang, B., Fu, W., Gao, X., Huang, J., Lai, Y., Li, L., Li, X., Li, Y., Liu, J., Liu, S., Ma, W., Ni, S., Qin, Z., Shi, G., Tian, H., Wang, S., Wang, L., Xiao, W., Ying, K., Yu, G., Yuan, Y., Zhang, J., Zhang, X., Zhang, L., Zhu, L., Chlumský, J., Chochola, J., Dunaj, M., Kovarova, K., Lang, P., Matoška, P., Podpera, I., Spacek, R., Stehlikova, O., Brønnum-Schou, J., Egstrup, K., Gislason, G., Jeppesen, J., May, O., Nielsen, H., Wiggers, H., Achkar, A., Aquilanti, S., Benhamou, Y., Brisot, D., Bura-Riviere, A., Castella, N., Elias, A., Falvo, N., Ferrari, E., Lacroix, P., Mahe, I., Meneveau, N., Messas, E., Mismetti, P., Montaclair, K., Mottier, D., Moumneh, T., Paleiron, N., Parent, F., Pernod, G., Sanchez, O., Schmidt, J., Simoneau, G., Stephan, D., Amann, B., Bauersachs, R., Beyer-Westendorf, J., Blessing, E., Czihal, M., Espinola-Klein, C., Kahrmann, G., Licka, M., Neumeister, A., Schellong, S., Boda, Z., Farkas, K., Gurzo, M., Katona, A., Riba, M., Sipos, G., Tóth, K., Braester, A., Elias, M., Gafter-Gvili, A., Gavish, D., Hussein, O., Lishner, M., Schiff, E., Spectre, G., Tzoran-Rozenthal, I., Zimlichman, R., Ageno, W., Agnelli, G., Bova, C., Garbelotto, R., Ghirarduzzi, A., Imberti, D., Pesavento, R., Porreca, E., Visonà, A., Flota Cervera, L., Llamas Esperón, G., Rodriguez-Gonzalez, D., Solis Morales, L., Boersma, W., ten Cate, H., Erdkamp, F., Grifioen-Keijzer, A., Marwijk Kooy, M., Meijer, K., Middeldorp, S., Swart-Heikens, J., Ten Wolde, M., Westerweel, P., Braithwaite, I., Harper, P., Merriman, E., Ockelford, P., Royle, G., Smith, M., Ghanima, W., Sandset, P.M., Abola, M., Chęciński, P., Grzelakowski, P., Lewczuk, J., Sobkowicz, B., Tomkowski, W., Abramov, I., Chechulov, P., Karpenko, A., Katelnitskiy, I., Kazakov, A., Makarova, O., Panchenko, E., Sergeeva, E., Subbotin, Y., Suchkov, I., Zeltser, M., Adler, D., Breedt, J., Fourie, N., Isaacs, R., Jacobson, B., Siebert, H., van Zyl, L., Choi, J-H, Kang, S-M, Kim, K-H, Kim, H-S, Kim, D-I, Min, S-K, Park, K.H., García-Bragado Dalmau, F., Gómez Cerezo, J., Mirete, JCF, Riera, A., Del Toro, J., Eriksson, H., Torstensson, I., Banyai, M., Baumgartner, I., Mazzolai, L., Periard, D., Righini, M., Staub, D., Chiang, C-E, Chiu, K-M, Pai, P-Y, Angchaisuksiri, P., Chansung, K., Öngen, G., Tuncay, E., Alikhan, R., Chetter, I., Kesteven, P., Nokes, T., Bauer, K., Comerota, A., Elias, D., Garcia, D., Gibson, K., Ginsberg, D., Jenkins, J., Kingsley, E., Lambert, R., Lyons, R., Pullman, J., Shah, V., Smith, S.W., Stein, R., Tapson, V., Walsh, J., Wang, T-F, Do Loi, D., Do Quang, H., and Pham, N.
Subjects: Male, [SDV]Life Sciences [q-bio], Phases of clinical research, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Factor Xa Inhibitors/administration & dosage/adverse effects, law.invention, TOTAL KNEE ARTHROPLASTY, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, ENOXAPARIN, law, Hemorrhage/chemically induced, Secondary Prevention, NONSURGICAL PATIENTS, 030212 general & internal medicine, THROMBOPROPHYLAXIS, ComputingMilieux_MISCELLANEOUS, ddc:616, Aspirin, Atrial fibrillation, General Medicine, Venous Thromboembolism, Middle Aged, Thrombosis, Intention to Treat Analysis, Anesthesia, Adult, Aged, Aspirin/administration & dosage, Aspirin/adverse effects, Double-Blind Method, Drug Administration Schedule, Factor Xa Inhibitors/administration & dosage, Factor Xa Inhibitors/adverse effects, Female, Humans, Platelet Aggregation Inhibitors/administration & dosage, Platelet Aggregation Inhibitors/adverse effects, Rivaroxaban/administration & dosage, Rivaroxaban/adverse effects, Venous Thromboembolism/mortality, Venous Thromboembolism/prevention & control, medicine.drug, medicine.medical_specialty, LONG-TERM, Platelet Aggregation Inhibitors/administration & dosage/adverse effects, Venous Thromboembolism/mortality/prevention & control, INTENSITY WARFARIN THERAPY, Hemorrhage, HIP-ARTHROPLASTY, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Thromboembolism, medicine, Mortalitat, Aspirina, Mortality, Tromboembolisme, Intention-to-treat analysis, business.industry, medicine.disease, PREVENTION, Surgery, Aspirin/administration & dosage/adverse effects, Clinical trial, THROMBOSIS, ATRIAL-FIBRILLATION, Rivaroxaban/administration & dosage/adverse effects, business, Platelet Aggregation Inhibitors, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Factor Xa Inhibitors
Abstract: Background: although many patients with venous thromboembolism require extended treatment, it is uncertain whether it is better to use full- or lower-intensity anticoagulation therapy or aspirin. Methods: in this randomized, double-blind, phase 3 study, we assigned 3396 patients with venous thromboembolism to receive either once-daily rivaroxaban (at doses of 20 mg or 10 mg) or 100 mg of aspirin. All the study patients had completed 6 to 12 months of anticoagulation therapy and were in equipoise regarding the need for continued anticoagulation. Study drugs were administered for up to 12 months. The primary efficacy outcome was symptomatic recurrent fatal or nonfatal venous thromboembolism, and the principal safety outcome was major bleeding. Results: a total of 3365 patients were included in the intention-to-treat analyses (median treatment duration, 351 days). The primary efficacy outcome occurred in 17 of 1107 patients (1.5%) receiving 20 mg of rivaroxaban and in 13 of 1127 patients (1.2%) receiving 10 mg of rivaroxaban, as compared with 50 of 1131 patients (4.4%) receiving aspirin (hazard ratio for 20 mg of rivaroxaban vs. aspirin, 0.34; 95% confidence interval [CI], 0.20 to 0.59; hazard ratio for 10 mg of rivaroxaban vs. aspirin, 0.26; 95% CI, 0.14 to 0.47; P
Published: 2017

38. Development of a Risk Prediction Score for Occult Cancer in Patients With VTE

Author: Luis Jara-Palomares, Remedios Otero, David Jimenez, Marc Carrier, Inna Tzoran, Benjamin Brenner, Mireia Margeli, Juan Manuel Praena-Fernandez, Elvira Grandone, Manuel Monreal, Hervè Decousus, Paolo Prandoni, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Philip Wells, Manolis Papadakis, M.A. Aibar, M. Alfonso, M.I. Asensio-Cruz, T. Auguet, J.I. Arcelus, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, T. Bueso, I. Cañas, A. Ceausu, N. Chic, A. Culla, R. del Pozo, J. del Toro, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, M. Duffort, T. Elias-Hernández, C. Falgá, C. Fernández-Aracil, C. Fernández-Capitán, M.A. Fidalgo, C. Font, L. Font, P. Gallego, M.A. García, F. García-Bragado, M. García-Rodenas, V. Gómez, J. González, E. Grau, A. Grimón, R. Guijarro, L. Guirado, J. Gutiérrez, G. Hernández-Comes, L. Hernández-Blasco, E. Hernando-López, L. Jara-Palomares, M.J. Jaras, D. Jiménez, M.D. Joya, P. Llamas, R. Lecumberri, J.L. Lobo, L. López-Jiménez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, A. Maestre, P.J. Marchena, M. Martín, F. Martín-Martos, M. Monreal, J.A. Nieto, S. Nieto, A. Núñez, M.J. Núñez, M. Odriozola, S. Otalora, R. Otero, A. Ovejero, J.M. Pedrajas, G. Pérez, C. Pérez-Ductor, M.L. Peris, J.A. Porras, O. Reig, A. Riera-Mestre, D. Riesco, A. Rivas, M.A. Rodríguez-Dávila, V. Rosa, P. Ruiz-Artacho, N. Ruiz-Giménez, J.C. Sahuquillo, M.C. Sala-Sainz, A. Sampériz, R. Sánchez, O. Sanz, S. Soler, B. Sopeña, J.M. Suriñach, C. Tolosa, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, P. Vicente, G. Vidal, A. Villalobos, J. Villalta, T. Vanassche, P. Verhamme, P. Wells, J. Hirmerova, R. Malý, E. Salgado, L. Bertoletti, A. Bura-Riviere, D. Farge-Bancel, A. Hij, I. Mahé, A. Merah, F. Moustafa, M. Papadakis, A. Braester, B. Brenner, I. Tzoran, G. Antonucci, G. Barillari, A. Bertone, F. Bilora, C. Bortoluzzi, M. Ciammaichella, C. Di Girolamo, P. Di Micco, R. Duce, P. Ferrazzi, M. Giorgi-Pierfranceschi, E. Grandone, C. Lodigiani, R. Maida, D. Mastroiacovo, F. Pace, R. Pesavento, M. Pinelli, R. Poggio, P. Prandoni, L. Rota, E. Tiraferri, D. Tonello, A. Tufano, A. Visonà, B. Zalunardo, E. Drucka, D. Kigitovica, A. Skride, M.S. Sousa, M. Bosevski, M. Zdraveska, H. Bounameaux, L. Mazzolai, Jara-Palomares, L., Otero, R., Jimenez, D., Carrier, M., Tzoran, I., Brenner, B., Margeli, M., Praena-Fernandez, J. M., Grandone, E., Monreal, M., Decousus, H., Prandoni, P., Barba, R., Di Micco, P., Bertoletti, L., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Wells, P., Papadakis, M., Aibar, M. A., Alfonso, M., Asensio-Cruz, M. I., Auguet, T., Arcelus, J. I., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Canas, I., Ceausu, A., Chic, N., Culla, A., del Pozo, R., del Toro, J., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Duffort, M., Elias-Hernandez, T., Falga, C., Fernandez-Aracil, C., Fernandez-Capitan, C., Fidalgo, M. A., Font, C., Font, L., Gallego, P., Garcia, M. A., Garcia-Bragado, F., Garcia-Rodenas, M., Gomez, V., Gonzalez, J., Grau, E., Grimon, A., Guijarro, R., Guirado, L., Gutierrez, J., Hernandez-Comes, G., Hernandez-Blasco, L., Hernando-Lopez, E., Jaras, M. J., Joya, M. D., Llamas, P., Lecumberri, R., Lobo, J. L., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Maestre, A., Marchena, P. J., Martin, M., Martin-Martos, F., Nieto, J. A., Nieto, S., Nunez, A., Nunez, M. J., Odriozola, M., Otalora, S., Ovejero, A., Pedrajas, J. M., Perez, G., Perez-Ductor, C., Peris, M. L., Porras, J. A., Reig, O., Riera-Mestre, A., Riesco, D., Rivas, A., Rodriguez-Davila, M. A., Rosa, V., Ruiz-Artacho, P., Ruiz-Gimenez, N., Sahuquillo, J. C., Sala-Sainz, M. C., Samperiz, A., Sanchez, R., Sanz, O., Soler, S., Sopena, B., Surinach, J. M., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Vicente, P., Vidal, G., Villalobos, A., Villalta, J., Vanassche, T., Verhamme, P., Hirmerova, J., Salgado, E., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Moustafa, F., Braester, A., Antonucci, G., Barillari, G., Bertone, A., Bilora, F., Bortoluzzi, C., Ciammaichella, M., Di Girolamo, C., Duce, R., Ferrazzi, P., Giorgi-Pierfranceschi, M., Lodigiani, C., Maida, R., Mastroiacovo, D., Pace, F., Pesavento, R., Pinelli, M., Poggio, R., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Drucka, E., Kigitovica, D., Skride, A., Sousa, M. S., Zdraveska, M., and Mazzolai, L.
Subjects: Pulmonary and Respiratory Medicine, Lung Diseases, Male, medicine.medical_specialty, Multivariate analysis, Anemia, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Internal medicine, Neoplasms, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Registries, risk, Aged, Aged, 80 and over, Thrombocytosis, Venous Thrombosis, Framingham Risk Score, business.industry, screening, Case-control study, Age Factors, Cancer, Reproducibility of Results, Venous Thromboembolism, Middle Aged, medicine.disease, Pulmonary embolism, Surgery, Spain, Case-Control Studies, Surgical Procedures, Operative, Cohort, Multivariate Analysis, Female, Cardiology and Cardiovascular Medicine, Risk assessment, business, Pulmonary Embolism, neoplasm
Abstract: Background The benefits of a diagnostic workup for occult cancer in patients with VTE are controversial. Our aim was to provide and validate a risk score for occult cancer in patients with VTE. Methods We designed a nested case-control study in a cohort of patients with VTE included in the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry from 2001 to 2014. Cases included cancer detected beyond the first 30 days and up to 24 months after VTE. Control subjects were defined as patients with VTE with no cancer in the same period. Results Of 5,863 eligible patients, 444 (7.6%; 95% CI, 6.8%-8.2%) were diagnosed with occult cancer. On multivariable analysis, variables selected were male sex, age > 70 years, chronic lung disease, anemia, elevated platelet count, prior VTE, and recent surgery. We built a risk score assigning points to each variable. Internal validity was confirmed using bootstrap analysis. The proportion of patients with cancer who scored ≤ 2 points was 5.8% (241 of 4,150) and that proportion in those who scored ≥ 3 points was 12% (203 of 1,713). We also identified scores divided by sex and age subgroups. Conclusions This is the first risk score that has identified patients with VTE who are at increased risk for occult cancer. Our score needs to be externally validated.
Published: 2016

39. DVT Management and Outcome Trends, 2001 to 2014

Author: Raquel Morillo, David Jiménez, Miguel Ángel Aibar, Daniela Mastroiacovo, Philip S. Wells, Ángel Sampériz, Marta Saraiva de Sousa, Alfonso Muriel, Roger D. Yusen, Manuel Monreal, Hervè Decousus, Paolo Prandoni, Benjamin Brenner, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Philip Wells, Manolis Papadakis, P. Agudo, M.A. Aibar, M. Akasbi, M. Alcalde-Manero, V. Andújar, J.I. Arcelus, A. Ballaz, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, I. Cañas, I. Casado, J. de Miguel, J. del Toro, S. Díaz, J.A. Díaz-Peromingo, C. Falgá, C. Fernández-Capitán, C. Font, L. Font, P. Gallego, F. García-Bragado, M. García-Rodenas, V. Gómez, C.J. González, E. Grau, L. Guirado, J. Gutiérrez, G. Hernández, L. Hernández-Blasco, V. Isern, L. Jara-Palomares, M.J. Jaras, D. Jiménez, J.L. Lobo, L. López-Jiménez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, P.J. Marchena, M. Martín, J.M. Martín-Antorán, F. Martín-Martos, M. Monreal, M.V. Morales, D. Nauffal, J.A. Nieto, S. Nieto, M.J. Núñez, C. Orbegoso, S. Otalora, R. Otero, B. Pagán, J.M. Pedrajas, C. Pérez, G. Pérez, M.L. Peris, I. Pons, J.A. Porras, O. Reig, A. Riera-Mestre, A. Rivas, C. Rodríguez, M.A. Rodríguez-Dávila, V. Rosa, A.S. Rosa-Murillo, N. Ruiz-Giménez, J.C. Sahuquillo, M.C. Sala, A. Sampériz, R. Sánchez, O. Sanz, S. Soler, J.M. Suriñach, C. Tolosa, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, G. Vidal, C. Vilar, J. Villalta, B. Xifre, T. Vanassche, P. Verhamme, P. Wells, J. Hirmerova, R. Malý, T. Tomko, G. Celis, E. Salgado, G.T. Sánchez, L. Bertoletti, A. Bura-Riviere, D. Farge-Bancel, A. Hij, I. Mahé, A. Merah, I. Quere, M. Papadakis, A. Braester, B. Brenner, I. Tzoran, A. Apollonio, G. Barillari, A. Bertone, F. Bilora, E. Bucherini, M. Ciammaichella, P. De Ciantis, F. Dentali, P. Di Micco, R. Duce, P. Ferrazzi, E. Grandone, G. Lessiani, C. Lodigiani, D. Mastroiacovo, F. Pace, R. Pesavento, M. Pinelli, R. Poggio, P. Prandoni, M. Rosa, L. Rota, E. Tiraferri, D. Tonello, A. Tufano, U. Venturelli, A. Visonà, B. Zalunardo, E. Drucka, D. Kigitovica, A. Skride, A. Mafalda, J.L. Ribeiro, M.S. Sousa, M. Bosevski, M. Zdraveska, H. Bounameaux, L. Mazzolai, Morillo, R., Jimenez, D., Aibar, M. A., Mastroiacovo, D., Wells, P. S., Samperiz, A., Saraiva de Sousa, M., Muriel, A., Yusen, R. D., Monreal, M., Decousus, H., Prandoni, P., Brenner, B., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Wells, P., Papadakis, M., Agudo, P., Akasbi, M., Alcalde-Manero, M., Andujar, V., Arcelus, J. I., Ballaz, A., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Canas, I., Casado, I., de Miguel, J., del Toro, J., Diaz, S., Diaz-Peromingo, J. A., Falga, C., Fernandez-Capitan, C., Font, C., Font, L., Gallego, P., Garcia-Bragado, F., Garcia-Rodenas, M., Gomez, V., Gonzalez, C. J., Grau, E., Guirado, L., Gutierrez, J., Hernandez, G., Hernandez-Blasco, L., Isern, V., Jara-Palomares, L., Jaras, M. J., Lobo, J. L., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin, M., Martin-Antoran, J. M., Martin-Martos, F., Morales, M. V., Nauffal, D., Nieto, J. A., Nieto, S., Nunez, M. J., Orbegoso, C., Otalora, S., Otero, R., Pagan, B., Pedrajas, J. M., Perez, C., Perez, G., Peris, M. L., Pons, I., Porras, J. A., Reig, O., Riera-Mestre, A., Rivas, A., Rodriguez, C., Rodriguez-Davila, M. A., Rosa, V., Rosa-Murillo, A. S., Ruiz-Gimenez, N., Sahuquillo, J. C., Sala, M. C., Sanchez, R., Sanz, O., Soler, S., Surinach, J. M., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Vidal, G., Vilar, C., Villalta, J., Xifre, B., Vanassche, T., Verhamme, P., Hirmerova, J., Tomko, T., Celis, G., Salgado, E., Sanchez, G. T., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Quere, I., Braester, A., Apollonio, A., Barillari, G., Bertone, A., Bilora, F., Bucherini, E., Ciammaichella, M., De Ciantis, P., Dentali, F., Duce, R., Ferrazzi, P., Grandone, E., Lessiani, G., Lodigiani, C., Pace, F., Pesavento, R., Pinelli, M., Poggio, R., Rosa, M., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Venturelli, U., Visona, A., Zalunardo, B., Drucka, E., Kigitovica, D., Skride, A., Mafalda, A., Ribeiro, J. L., Sousa, M. S., Zdraveska, M., and Mazzolai, L.
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Vena Cava Filters, Hemorrhage, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Rate ratio, survival, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Cause of Death, medicine, Humans, Thrombolytic Therapy, Registries, 030212 general & internal medicine, Mortality, Population Growth, Intensive care medicine, Aged, Retrospective Studies, Aged, 80 and over, Venous Thrombosis, business.industry, Anticoagulants, Disease Management, Heparin, Low-Molecular-Weight, Length of Stay, Middle Aged, Prognosis, medicine.disease, Pulmonary embolism, Emergency medicine, Female, Cardiology and Cardiovascular Medicine, business, Venous thromboembolism, Hospital stay, DVT, prognosi
Abstract: Background A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes. Methods We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26,695 adults with DVT enrolled in the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2014. We also examined temporal trends in risk-adjusted rates of all-cause, pulmonary embolism-related, and bleeding-related death to 30 days after diagnosis. Results The mean length of hospital stay decreased from 9.0 days in 2001 to 2005 to 7.6 days in 2010 to 2014 (P
Published: 2016

40. Platelet Count and Major Bleeding in Patients Receiving Vitamin K Antagonists for Acute Venous Thromboembolism, Findings From Real World Clinical Practice

Author: Giorgi-Pierfranceschi, Mateo, Di Micco, Pierpaolo, Cattabiani, Chiara, Guida, Anna, Pagán, Barbara, Morales, María del Valle, Salgado, Estuardo, Suriñach, Jose María, Tolosa, Carles, Monreal, Manuel, RIETE Investigators, RIETE Investigators, Adarraga, M.D., Andújar, V., Arcelus, J.I., Ballaz, A., Barba, R., Barrón, M., Blanco-Molina, A., Casado, I., Castejón-Pina, N., de Miguel, J., del Molino, F., del Toro, J., Diaz, J.A., Falga, C., Font, L., Gallego, P., Garcia- Bragado, F., Gómez, V., González, J., Grau, E., Guijarro, R., Guirado, L., ndez-Blasco, L., Hernández- Huerta, S., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Lacruz, B., Lecumberri, R., Lobo, J.L., López-Reyes, R., Sáez, J.B., Lorente, M.A., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P.J., Martin-Martos, F., Monreal, M., Morales, M.V., Nauffal, D., Nieto, J.A., Odriozola, M., Otero, R., Pagán, B., Pedrajas, J.M., Pérez, G., Peris, M.L., Pons, I., Porras, J.A., Riera-Mestre, A., Rivas, A., Rosa, V., Sabio, P., Sampériz, A., Sánchez, R., Sanz, O., Soler, S., Suriñach, J.M., Tiberio, G., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Vela, L., Vidal, G., Vilar, C., Villalobos, A., Villalta, J., Xifre, B., Vanassche, T., Verhamme, P., Wells, P., Hirmerova, J., Maly, R., Salgado, E., Bertoletti, L., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Moustafa, F., Schellong, S., Babalis, D., Papadakis, M., Tzinieris, I., Braester, A., Brenner, B., Tzoran, I., Apollonio, A., Barillari, G., Bucherini, E., Ciammaichella, M., Cola, S., Di Micco, P., Enea, I., Ferrazzi, P., Guida, A., Lessiani, G., Lodigiani, C., Maida, R., Mastroiacovo, D., Pace, F., Pasca, S., Pesavento, R., Pinelli, M., Piovella, C., Prandoni, P., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Belovs, A., Sablinskis, K., Skride, A., Ribeiro, F., Ribeiro, J.L., Bosevski, M., Zdraveska, M., Alatri, A., Bounameaux, H., Calanca, L., and Mazzolai, L.
Subjects: Male, medicine.medical_specialty, Vitamin K, Observational Study, Hemorrhage, Abnormal platelet count, Vitamin k, Gastroenterology, Aged, Anticoagulants, Female, Fibrinolytic Agents, Follow-Up Studies, Humans, International Normalized Ratio, Middle Aged, Registries, Treatment Outcome, Venous Thromboembolism, Platelet Count, Internal medicine, medicine, Platelet, In patient, business.industry, General Medicine, Surgery, Clinical Practice, Anticoagulants/adverse effects, Anticoagulants/therapeutic use, Fibrinolytic Agents/adverse effects, Fibrinolytic Agents/therapeutic use, Hemorrhage/chemically induced, Hemorrhage/epidemiology, Venous Thromboembolism/drug therapy, business, Venous thromboembolism, Major bleeding, Fibrinolytic agent, Research Article
Abstract: The outcome of patients with acute venous thromboembolism (VTE) and abnormal platelet count (PlC) at baseline has not been consistently studied. In real-world clinical practice, a number of patients with abnormal PlC receive vitamin K antagonists (VKAs) to treat acute VTE despite their higher risk of bleeding. We used the Registro Informatizado de Enfermedad TromboEmbólica registry database to compare the rate of major bleeding in patients receiving VKA for long-term therapy of acute VTE according to PlC levels at baseline. Patients were categorized as having very low (450,000/μL) PlC at baseline. Of 55,369 patients recruited as of January 2015, 37,000 (67%) received long-term therapy with VKA. Of these, 611 patients (1.6%) had very low PlC, 4006 (10.8%) had low PlC, 25,598 (69%) had normal PlC, 5801 (15.6%) had high PlC, and 984 (2.6%) had very high PlC at baseline. During the course of VKA therapy (mean, 192 days), there were no differences in the duration or intensity (as measured by international normalized ratio levels) of treatment between subgroups. The rate of major bleeding was 3.6%, 2.1%, 1.9%, 2.1%, and 3.7%, respectively, and the rate of fatal bleeding was 0.98%, 0.17%, 0.29%, 0.34%, and 0.50%, respectively. Patients with very low or very high PlC levels were more likely to have severe comorbidities. We found a nonlinear “U-shaped” relationship between PlC at baseline and major bleeding during therapy with VKA for VTE. Consistent alteration of PlC values at baseline suggested a greater frailty.
Published: 2015

41. A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity

Author: V. Rosa‐Salazar, J. Trujillo‐Santos, J.A. Díaz Peromingo, A. Apollonio, O. Sanz, R. Malý, F.J. Muñoz‐Rodriguez, J.C. Serrano, S. Soler, M. Monreal, H. Decousus, P. Prandoni, B. Brenner, R. Barba, P. Di Micco, L. Bertoletti, S. Schellong, I. Tzoran, A. Reis, M. Bosevski, H. Bounameaux, P. Wells, M. Papadakis, M.D. Adarraga, A. Alibalic, A. Alvarado‐Faria, J.I. Arcelus, T. Auguet, A. Ballaz, M. Barrón, B. Barrón‐Andrés, J. Bascuñana, J.F. Benítez, A. Blanco‐Molina, T. Bueso, A. Cañas, A. Casado, N. Castejón‐Pina, E.L. Chaves, F del Molino, J del Toro, C. Falgá, C. Fernández‐Capitán, L. Font, P. Gallego, F. García‐Bragado, A. García‐Ortega, V. Gómez, J. González, D. González‐Marcano, E. Grau, R. Guijarro, M. Guil, L. Guirado, J. Gutiérrez‐Guisado, L. Hernández‐Blasco, L. Jara‐Palomares, M.J. Jaras, D. Jiménez, R. Jiménez, B. Lacruz, R. Lecumberri, J.L. Lobo, L. López‐Jiménez, L. López‐Montes, R. López‐Reyes, J.B. López‐Sáez, M.A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, P.J. Marchena, J.M. Martín‐Antorán, F. Martín‐Martos, M.V. Morales, D. Nauffal, J.A. Nieto, M.J. Núñez, S. Otalora, R. Otero, B. Pagán, J.M. Pedrajas, M.L. Peris, I. Pons, J.A. Porras, A. Riera‐Mestre, A. Rivas, M.A. Rodríguez‐Dávila, N. Ruiz‐Giménez, P. Sabio, A. Sampériz, R. Sánchez, M.J. Soto, J.M. Suriñach, G. Tiberio, R. Tirado, C. Tolosa, F. Uresandi, B. Valero, R. Valle, J. Vela, A. Villalobos, J. Villalta, P. Malfante, P. Verhamme, T. Vanassche, T. Tomko, J. Hirmerova, A. Bura‐Riviere, D. Farge‐Bancel, A. Hij, I. Mahe, A. Merah, F. Moustafa, I. Quere, D. Babalis, I. Tzinieris, A. Braester, G. Barillari, E. Bucherini, J. Campodomico, M. Ciammaichella, P. Ferrazzi, R. Maida, F. Pace, S. Pasca, R. Pesavento, C. Piovella, L. Rota, E. Tiraferri, A. Tufano, A. Visonà, A. Skride, A. Belovs, M. Moreira, J.L. Ribeiro, M.S. Sousa, A. Alatri, L. Calanca, L. Mazzolai, Rosa-Salazar, V., Trujillo-Santos, J., Diaz Peromingo, J. A., Apollonio, A., Sanz, O., Maly, R., Munoz-Rodriguez, F. J., Serrano, J. C., Soler, S., Monreal, M., Decousus, H., Prandoni, P., Brenner, B., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Wells, P., Papadakis, M., Adarraga, M. D., Alibalic, A., Alvarado-Faria, A., Arcelus, J. I., Auguet, T., Ballaz, A., Barron, M., Barron-Andres, B., Bascunana, J., Benitez, J. F., Blanco-Molina, A., Bueso, T., Canas, A., Casado, A., Castejon-Pina, N., Chaves, E. L., del Molino, F., del Toro, J., Diaz, J. A., Falga, C., Fernandez-Capitan, C., Font, L., Gallego, P., Garcia-Bragado, F., Garcia-Ortega, A., Gomez, V., Gonzalez, J., Gonzalez-Marcano, D., Grau, E., Guijarro, R., Guil, M., Guirado, L., Gutierrez-Guisado, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, R., Lacruz, B., Lecumberri, R., Lobo, J. L., Lopez-Jimenez, L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin-Antoran, J. M., Martin-Martos, F., Montreal, M., Morales, M. V., Nauffal, D., Nieto, J. A., Nunez, M. J., Otalora, S., Otero, R., Pagan, B., Pedrajas, J. M., Peris, M. L., Pons, I., Porras, J. A., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Ruiz-Gimenez, N., Sabio, P., Samperiz, A., Sanchez, R., Soto, M. J., Surinach, J. M., Tiberio, G., Tirado, R., Tolosa, C., Uresandi, F., Valero, B., Valle, R., Vela, J., Villalobos, A., Verhamme, P., Tomko, T., Villalta, J., Malfante, P., Mahe, I., Vanassche, T., Moustafa, F., Babalis, D., Hirmerova, J., Barillari, G., Bucherini, E., Farge-Bance, D., Ciammaichella, M., Ferrazzi, P., Maida, R., Pace, F., Quere, I., Pesavento, R., Piovella, C., Rota, L., Tzinieris, I., Tufano, A., Skride, A., Moreira, M., Ribeiro, J. L., Alatri, A., Calanca, L., Visona, A., Belovs, A., Sousa, M. S., Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)
Subjects: Adult, Male, Canada, medicine.medical_specialty, Time Factors, Upper extremity, Deep vein, Renal function, Hemorrhage, Risk Assessment, deep vein thrombosis, Decision Support Techniques, Hospital, Predictive Value of Tests, Risk Factors, Deep vein thrombosi, Upper Extremity Deep Vein Thrombosis, Humans, Medicine, Registries, Israel, Adverse effect, Anticoagulant therapy, Aged, Outcome, Deep vein thrombosis, Outpatients, Anticoagulants, Europe, Female, Middle Aged, Pulmonary Embolism, South America, Treatment Outcome, business.industry, Cancer, Outpatient, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, medicine.disease, Thrombosis, Confidence interval, 3. Good health, Pulmonary embolism, Surgery, outpatients, medicine.anatomical_structure, Heart failure, business
Abstract: International audience; BACKGROUND:No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy.METHODS:We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week.RESULTS:As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min(-1) , recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels < 30 mL min(-1) . Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055.CONCLUSIONS:Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.
Published: 2015

42. Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation

Author: Inna Tzoran, Manolis Papadakis, Benjamin Brenner, Ángeles Fidalgo, Agustina Rivas, Philip S. Wells, Olga Gavín, María Dolores Adarraga, Farès Moustafa, Manuel Monreal, Hervé Decousus, Paolo Prandoni, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Philip Wells, M.D. Adarraga, M.A. Aibar, M. Alfonso, J.I. Arcelus, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, T. Bueso, G. Cañada, I. Cañas, N. Chic, R. del Pozo, J. del Toro, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, C. Falgá, C. Fernández-Capitán, M.A. Fidalgo, C. Font, L. Font, P. Gallego, A. García, M.A. García, F. García-Bragado, P. García-Brotons, O. Gavín, C. Gómez, V. Gómez, J. González, D. González-Marcano, E. Grau, A. Grimón, R. Guijarro, J. Gutiérrez, G. Hernández-Comes, L. Hernández-Blasco, M.J. Hermosa-Los Arcos, L. Jara-Palomares, M.J. Jaras, D. Jiménez, M.D. Joya, P. Llamas, R. Lecumberri, J.L. Lobo, P. López, L. López-Jiménez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, A. Maestre, P.J. Marchena, F. Martín-Martos, M. Monreal, J.A. Nieto, S. Nieto, A. Núñez, M.J. Núñez, M. Odriozola, R. Otero, J.M. Pedrajas, G. Pérez, C. Pérez-Ductor, M.L. Peris, J.A. Porras, O. Reig, A. Riera-Mestre, D. Riesco, A. Rivas, C. Rodríguez, M.A. Rodríguez-Dávila, V. Rosa, N. Ruiz-Giménez, J.C. Sahuquillo, M.C. Sala-Sainz, A. Sampériz, R. Sánchez-Martínez, R. Sánchez Simón-Talero, O. Sanz, S. Soler, J.M. Suriñach, M.I. Torres, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, M.P. Vicente, A. Villalobos, T. Vanassche, P. Verhamme, P. Wells, J. Hirmerova, R. Malý, T. Tomko, G. del Pozo, E. Salgado, G.T. Sánchez, L. Bertoletti, A. Bura-Riviere, I. Mahé, A. Merah, F. Moustafa, M. Papadakis, A. Braester, B. Brenner, I. Tzoran, G. Antonucci, G. Barillari, F. Bilora, C. Bortoluzzi, C. Cattabiani, M. Ciammaichella, J. Di Biase, P. Di Micco, R. Duce, P. Ferrazzi, M. Giorgi-Pierfranceschi, E. Grandone, E. Imbalzano, C. Lodigiani, R. Maida, D. Mastroiacovo, F. Pace, R. Pesavento, M. Pinelli, R. Poggio, P. Prandoni, L. Rota, E. Tiraferri, D. Tonello, A. Tufano, A. Visonà, B. Zalunardo, V. Gibietis, A. Skride, B. Vitola, P. Monteiro, J.L. Ribeiro, M.S. Sousa, M. Bosevski, M. Zdraveska, H. Bounameaux, L. Calanca, A. Erdmann, L. Mazzolai, Tzoran, I., Papadakis, M., Brenner, B., Fidalgo, A., Rivas, A., Wells, P. S., Gavin, O., Adarraga, M. D., Moustafa, F., Monreal, M., Decousus, H., Prandoni, P., Barba, R., Di Micco, P., Bertoletti, L., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Wells, P., Aibar, M. A., Alfonso, M., Arcelus, J. I., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Canada, G., Canas, I., Chic, N., del Pozo, R., del Toro, J., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Falga, C., Fernandez-Capitan, C., Fidalgo, M. A., Font, C., Font, L., Gallego, P., Garcia, A., Garcia, M. A., Garcia-Bragado, F., Garcia-Brotons, P., Gomez, C., Gomez, V., Gonzalez, J., Gonzalez-Marcano, D., Grau, E., Grimon, A., Guijarro, R., Gutierrez, J., Hernandez-Comes, G., Hernandez-Blasco, L., Hermosa-Los Arcos, M. J., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Joya, M. D., Llamas, P., Lecumberri, R., Lobo, J. L., Lopez, P., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Maestre, A., Marchena, P. J., Martin-Martos, F., Nieto, J. A., Nieto, S., Nunez, A., Nunez, M. J., Odriozola, M., Otero, R., Pedrajas, J. M., Perez, G., Perez-Ductor, C., Peris, M. L., Porras, J. A., Reig, O., Riera-Mestre, A., Riesco, D., Rodriguez, C., Rodriguez-Davila, M. A., Rosa, V., Ruiz-Gimenez, N., Sahuquillo, J. C., Sala-Sainz, M. C., Samperiz, A., Sanchez-Martinez, R., Sanchez Simon-Talero, R., Sanz, O., Soler, S., Surinach, J. M., Torres, M. I., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Vicente, M. P., Villalobos, A., Vanassche, T., Verhamme, P., Hirmerova, J., Tomko, T., del Pozo, G., Salgado, E., Sanchez, G. T., Bura-Riviere, A., Mahe, I., Merah, A., Braester, A., Antonucci, G., Barillari, G., Bilora, F., Bortoluzzi, C., Cattabiani, C., Ciammaichella, M., Di Biase, J., Duce, R., Ferrazzi, P., Giorgi-Pierfranceschi, M., Grandone, E., Imbalzano, E., Lodigiani, C., Maida, R., Mastroiacovo, D., Pace, F., Pesavento, R., Pinelli, M., Poggio, R., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Gibietis, V., Skride, A., Vitola, B., Monteiro, P., Ribeiro, J. L., Sousa, M. S., Zdraveska, M., Calanca, L., Erdmann, A., and Mazzolai, L.
Subjects: Male, Heterozygote, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Hemorrhage, 030204 cardiovascular system & hematology, Gene mutation, Thrombophilia, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Factor V Leiden, Humans, Anticoagulant therapy, Activated Protein C Resistance, Rivaroxaban, biology, business.industry, Bleeding, Factor V, Anticoagulants, General Medicine, Middle Aged, medicine.disease, Surgery, Treatment Outcome, Mutation, biology.protein, Prothrombin G20210A, Female, Prothrombin, Activated protein C resistance, business, Venous thromboembolism, 030215 immunology, medicine.drug
Abstract: Background Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored. Methods We used the Registro Informatizado de Enfermedad TromboEmbolica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers. Results Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57). Conclusions During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.
Published: 2017

43. A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs

Author: S. Pasca, M.D. Adarraga, Manuel Monreal, M.J. Jaras, Sebastian Schellong, R. Maida, C. Piovella, Dolores Adarraga, F. García-Bragado, Ramón Lecumberri, J.A. Nieto, M. Mellado, Remedios Otero, Isabelle Quéré, Lucia Mazzolai, Radovan Malý, P. Malfante, V. Rosa, M. Farès, M. Alcalde, M. Kaletova, L. López-Jiménez, R. Pesavento, S. Almeida, R. Duce, F. Conget, M.L. Peris, J.M. Luque, B. Pagán, M.A. Rodríguez-Dávila, E. González-Bachs, I. Casado, T. Tomko, Peter Verhamme, J. Ruiz, A. Alatri, A. Apollonio, D. Zeltser, J.A. Porras, Olga Madridano, J.B. López-Sáez, Henri Bounameaux, Giovanni Barillari, Laurent Bertoletti, David Jiménez, A. Merah, N. Ruiz-Giménez, J. Gutiérrez, R. Guijarro, J.M. Suriñach, L. López-Montes, R. Jiménez, Jorge Del Toro, V. Andújar, J. del Toro, I. Pons, J. Trujillo-Santos, Alicia Lorenzo, P. Gallego, Jana Hirmerova, G. Pérez-Rus, E. Grau, M. Guil, M. Monreal, Manuel Alejandro Lorente, J.L. Ogea, Dolores Nauffal, Barry M. Brenner, J. González, L. Calanca, L. Mazzolai, A. Bura-Riviere, M.A. Lorente, Antoni Riera-Mestre, Inna Tzoran, G. Tiberio, J. Hirmerova, Silvia Soler, Paolo Prandoni, C. Grange, V. Gómez, Francisco Lozano, J.M. Martín-Antorán, F. Leal-Seabra, Adriana Visonà, A. Braester, Juan I. Arcelus, Luis Jara-Palomares, J.M. Pedrajas, F. del Molino, A. Blanco-Molina, J.C. Serrano, P.J. Marchena, A. Tufano, J. Vela, B. Valero, R. Poggio, Diego Tonello, M.J. Núñez, L. Rota, Agustina Rivas, José Luis Lobo, T. Bueso, Raquel López-Reyes, Javier Trujillo-Santos, P. Di Micco, Marijan Bosevski, Raúl Sánchez, J. Bascuñana, Isabelle Mahé, M. Barrón, Fernando Uresandi, L. Font, Philip S. Wells, A. Guida, E. Tiraferri, G. Barillari, P. Román, M. Ciammaichella, B. Zalunardo, Ángel Sampériz, Carmen Fernández-Capitán, F. Pace, Manolis Papadakis, R. Valle, M.S. Sousa, P. Sabio, Conxita Falga, A. Climent, A. Villalobos, Raquel Barba, M.V. Morales, K. Peerlinck, B. Barrón-Andrés, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Trujillo-Santos, J., Lozano, F., Lorente, M. A., Adarraga, D., Hirmerova, J., Toro, J. D., Mazzolai, L., Barillari, G., Barron, M., Monreal, M., Alcalde, M., Andujar, V., Arcelus, J. I., Barba, R., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Bueso, T., Casado, I., Climent, A., Conget, F., Del, M. F., Falga, C., Fernandez-Capitan, C., Font, L., Gallego, P., Garcia-Bragado, F., Gomez, V., Gonzalez, J., Gonzalez-Bachs, E., Grau, E., Guijarro, R., Guil, M., Gutierrez, J., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Jimenez, R., Lecumberri, R., Lobo, J. L., Lopez-Jimenez, L., Lopez-Montes, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorenzo, A., Luque, J. M., Madridano, O., Marchena, P. J., Martin-Antoran, J. M., Mellado, M., Morales, M. V., Nauffal, D., Nieto, J. A., Nunez, M. J., Ogea, J. L., Otero, R., Pagan, B., Pedrajas, J. M., Perez-Rus, G., Peris, M. L., Porras, J. A., Pons, I., Riera-Mestre, A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Sabio, P., Samperiz, A., Sanchez, R., Soler, S., Surinach, J. M., Tiberio, G., Uresandi, F., Valero, B., Valle, R., Vela, J., Villalobos, A., Malfante, P., Verhamme, P., Peerlinck, K., Wells, P., Maly, R., Kaletova, M., Tomko, T., Bertoletti, L., Bura-Riviere, A., Fares, M., Grange, C., Mahe, I., Merah, A., Quere, I., Schellong, S., Papadakis, M., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Apollonio, A., Ciammaichella, M., Di, M. P., Duce, R., Guida, A., Maida, R., Pace, F., Pasca, S., Piovella, C., Pesavento, R., Poggio, R., Prandoni, P., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Almeida, S., Leal-Seabra, F., Sousa, M. S., Bosevski, M., Alatri, A., Bounameaux, H., Calanca, L., and Serrano, J. C.
Subjects: Adult, Male, medicine.medical_specialty, Deep vein, Anticoagulant therapy, Deep venous thrombosis, Home, Hospital, Outcome, Aged, Aged, 80 and over, Ambulatory Care, Anticoagulants, Female, Humans, Lower Extremity, Middle Aged, Outpatients, Prognosis, Risk Assessment, Venous Thrombosis, Prognostic score, 80 and over, medicine, Adverse effect, Deep venous thrombosi, business.industry, Cancer, General Medicine, medicine.disease, Thrombosis, Confidence interval, 3. Good health, Surgery, Pulmonary embolism, medicine.anatomical_structure, Heart failure, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND:No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy.METHODS:We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home.RESULTS:As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001).CONCLUSIONS:Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated.
Published: 2014

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