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326 results on '"Lacut K"'

56. [Prolongation of anti vitamin K treatment for 18 months versus placebo after 6 months treatment of a first episode of ideopathic pulmonary embolism: a mutlicentre, randomised double blind trail. The PADIS-EP Trial]

Author

Couturaud, F., Pernod, G., Pison, C., Mismetti, P., Sanchez, O., Meyer, G., Parent, F., Girard, Pascal, Simonneau, G., Drouet, L., Gueret, P., Jego, P., Delaval, P., Duhamel, E., Gruel, Y., Delahousse, B., Regina, S., Pottier, Patrick, Connaud, J., Lecomte, F., Provost, K., Vilmans, N., Gosset, X., Bura-Rivière, A., Meach, G., Lacut, K., Bosson, J.-L., Guillot, K., Mottier, D., Leroyer, C., Mismetti, Patrick, 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), Laboratoire d'Hématologie, CHU Grenoble, Département de médecine aiguë spécialisée, CHU Grenoble-Hôpital Michallon, Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Departamento de Matemática Aplicada, Universidad de Granada (UGR)-Facultad de Ciencias, Ecole Vétérinaire de Toulouse, Service de pneumologie [Béclère], AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Cytokines, chimiokines et immunopathologie, Université Paris-Sud - Paris 11 (UP11)-IFR13-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Biochimie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-IFR6, Fédération de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine interne, hôpital Sud, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Littoral, Environnement, Télédétection, Géomatique (LETG - Nantes), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Brest (UBO)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Institut de Géographie et d'Aménagement Régional de l'Université de Nantes (IGARUN), Université de Nantes (UN)-Université de Nantes (UN), Service d'angiologie, 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), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Géographie et d'Aménagement Régional de l'Université de Nantes (IGARUN), Université de Nantes (UN)-Université de Nantes (UN)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Université de Caen Normandie (UNICAEN), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM)

Subjects
MESH: Pulmonary Embolism, Time Factors, Vitamin K, MESH: Chi-Square Distribution, MESH: Placebos, Hemorrhage, MESH: Anticoagulants, MESH: Risk Assessment, Risk Assessment, MESH: Prognosis, MESH: Venous Thromboembolism, Placebos, Double-Blind Method, MESH: Practice Guidelines as Topic, Recurrence, Humans, MESH: Double-Blind Method, cardiovascular diseases, MESH: Warfarin, Chi-Square Distribution, MESH: Humans, MESH: Time Factors, Anticoagulants, MESH: Vitamin K, Venous Thromboembolism, Prognosis, MESH: Recurrence, Data Interpretation, Statistical, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Practice Guidelines as Topic, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Warfarin, Pulmonary Embolism, MESH: Data Interpretation, Statistical, MESH: Hemorrhage
Abstract

International audience; BACKGROUND: After stopping a 3 to 6 months course of oral anticoagulation for a first episode of idiopathic venous thromboembolism (VTE), the risk of recurrent VTE is high (10% per year). In this setting, international guidelines recommend at least 6 months treatment. However, this recommendation is not satisfactory for the following reasons: (1) no randomized trial has compared 6 months to extended duration (2 years) anticoagulation; and (2), even though the frequency of recurrent VTE is similar after pulmonary embolism (PE) and deep vein thrombosis (DVT), the fatality rate of recurrent VTE after PE is higher than that after DVT. METHODS: A French multicentre double blind randomized trial. The main objective is to demonstrate, after a first episode of symptomatic idiopathic PE treated for 6 months using a vitamin K antagonist, that extended anticoagulation for 18 months (INR between 2 and 3) is associated with an increased benefit / risk ratio (recurrent VTE and severe anticoagulant-related bleeding) compared to placebo. The double blind evaluation is ensured using by active warfarin and placebo, and blinded INR. The protocol was approved by the ethics board of the Brest Hospital on the 7th of March 2006. For an alpha risk of 5% and a beta risk of 20%, the estimated sample size is 374 patients. EXPECTED RESULTS: This study has the potential to: (1) demonstrate that the benefit / risk ratio of extended anticoagulation for 18 months is higher than that observed with placebo in patients with a first episode of idiopathic PE initially treated for 6 months, during and after the treatment period; and (2) to validate or invalidate the contribution of isotope lung scans, lower limb Doppler ultrasound and D-Dimer at 6 months of treatment as predictors of recurrent VTE (medico-economic analysis included).

Published
2008

57. High plasma concentration of factor VIII coagulant is also a risk factor for venous thromboembolism in the elderly

Author

Oger, E., Lacut, K., Patrick Van Dreden, Bressollette, L., Abgrall, J. -F, Blouch, M. -T, Scarabin, P. -Y, Mottier, D., Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'hématologie biologique, Centre de recherche en épidémiologie et santé des populations (CESP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Aged, 80 and over, Male, Venous Thrombosis, MESH: Age Factors, MESH: Aged, Factor VIII, MESH: Humans, MESH: Middle Aged, Age Factors, Middle Aged, MESH: Factor VIII, MESH: Male, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, MESH: Thromboembolism, Thromboembolism, MESH: Venous Thrombosis, Humans, Female, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Aged
Abstract

International audience; BACKGROUND AND OBJECTIVES: A high level of coagulant factor VIII is a well known risk factor for venous thromboembolism, but most studies have enrolled patients under 70 years old. This study aimed to test the hypothesis that an association also exists in the elderly. DESIGN AND METHODS: This hospital-based case-referent study took place at the Department of Internal Medicine and Chest Diseases, University Hospital, Brest, France. We enrolled 161 patients with a first episode of venous thrombosis and 239 subjects, referred for a clinical suspicion of venous thromboembolism which was subsequently ruled out. Factor VIII coagulant activity and plasma fibrinogen concentration were measured. RESULTS: High factor VIII coagulant activity was significantly associated with venous thromboembolism, irrespective of the age group. Patients over 70 years with factor VIII coagulant activity above 225% had a 2.4-fold increased risk of venous thromboembolism compared to those patients with levels below 130% (age- and fibrinogen-adjusted odds ratio: 2.6, 95% CI 1.1 to 6.1). INTERPRETATION AND CONCLUSIONS: Our results show that high levels of factor VIII coagulant, a determinant of venous thrombosis in adulthood, is also a risk factor in the elderly.

Published
2003

58. Differential effects of oral and transdermal estrogen/progesterone regimens on sensitivity to activated protein C among postmenopausal women: A randomized trial.

Author

Roudaut N., Oger E., Alhenc-Gelas M., Lacut K., Blouch M.-T., Mottier D., Scarabin P.-Y., Aiach M., Abgrall J.-F., Collet M., Kerlan V., Roudaut N., Oger E., Alhenc-Gelas M., Lacut K., Blouch M.-T., Mottier D., Scarabin P.-Y., Aiach M., Abgrall J.-F., Collet M., and Kerlan V.

Abstract

Objective - Activated protein C (APC) resistance not related to the factor V Leiden mutation is a risk factor for venous thrombosis. Oral estrogen replacement therapy (ERT) has been reported to induce APC resistance. Little is known about the effect of transdermal estrogen. Methods and Results - We enrolled 196 postmenopausal women who were randomly allocated to receive either 1 mg 17beta-estradiol orally (n=63) or 50 mug 17beta-estradiol transdermally per day (n=68), both associated with 100 mg progesterone daily or placebo (n=65) for 6 months. An activated partial thromboplastin time (APTT)-based test and the effect of APC on thrombin potential (ETP) were used. Oral ERT induced an ETP-based APC resistance compared with both placebo (P=0.006) and transdermal ERT (P<0.001), but there was no significant effect of transdermal ERT compared with placebo (P=0.191). There was no significant effect of ERT on the APTT-based APC sensitivity ratio. Prothrombin fragment 1+2 plasma levels were significantly higher after 6 months of treatment in women allocated to oral ERT compared with those on placebo and transdermal ERT and were positively and significantly correlated with changes in ETP-based APC sensitivity ratio. Conclusions - Our data show that oral, unlike transdermal, estrogen induces APC resistance and activates blood coagulation. These results emphasize the importance of the route of estrogen administration.

Published
2012

69. OP5-5 Evaluation of a new strategy for cervix cancer screening in women who do not access to pap smear screening in West Brittany, using a urine test for human papillomavirus (HPV) detection on a large scale plateform combining EasyMag extractor and real-time PCR LightCycler system (the PAPU29 PHASE 1 study)

Author

Payan, C., primary, Tran, A., additional, Foll, Y., additional, Vallon, C., additional, Poulhazan, E., additional, Lacut, K., additional, Charles, F., additional, Herry, F., additional, Postec, E., additional, and Collet, M., additional

Published
2009
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74. Prolongation d’un traitement par antivitamine K pendant dix-huit mois versus placebo au décours d’un premier épisode d’embolie pulmonaire idiopathique traité six mois : un essai randomisé multicentrique en double aveugle. Essai « PADIS-EP »

Author

Couturaud, F., primary, Pernod, G., additional, Pison, C., additional, Mismetti, P., additional, Sanchez, O., additional, Meyer, G., additional, Parent, F., additional, Girard, P., additional, Simonneau, G., additional, Drouet, L., additional, Gueret, P., additional, Jego, P., additional, Delaval, P., additional, Duhamel, E., additional, Gruel, Y., additional, Delahousse, B., additional, Regina, S., additional, Pottier, P., additional, Connaud, J., additional, Lecomte, F., additional, Provost, K., additional, Vilmans, N., additional, Gosset, X., additional, Bura-Rivière, A., additional, Meach, G., additional, Lacut, K., additional, Bosson, J.-L., additional, Guillot, K., additional, Mottier, D., additional, and Leroyer, C., additional

Published
2008
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91. Incidence and acquired risk factors for thrombophlebitis

Author

Oger, E., Lacut, K., and Scarabin, P.Y.

Subjects
*THROMBOSIS risk factors, *DISEASES in older people
Abstract

Deep vein thrombosis is a frequent disease with an annual incidence reaching 5 per thousand among subjects over 75 years. Major acquired risk factors for venous thrombosis include surgery, neoplasm, reduced mobility or paresis, and a previous episode of deep vein thrombosis. Among women, hormonal status (pregnancy, oral contraceptive, hormone replacement therapy) is responsible for the majority of all venous thrombotic events. The impact of other factors is controversial: obesity, tobacco use and varicose veins. Venous thrombosis is a multifactorial disease and analysis of the interactions between acquired and inherited risk factors is an extremely interesting field of investigation. [Copyright &y& Elsevier]

Published
2002

94. Differential effects of oral and transdermal postmenopausal estrogen replacement therapies on C-reactive protein

Author

Abgrall, J. -F, Blouch, M. -T, Kerlan, V., Lacut, K., Grégoire LE GAL, Mottier, D., Oger, E., Scarabin, P. -Y, 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), Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes], Service d'hématologie biologique, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'Endocrinologie (CHRU - Endocrino), Centre de recherche en épidémiologie et santé des populations (CESP), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Aged, MESH: Humans, MESH: Middle Aged, MESH: Hormone Replacement Therapy, MESH: Thrombophilia, MESH: Adult, MESH: Follow-Up Studies, MESH: Interleukin-6, MESH: Administration, Cutaneous, MESH: Progesterone, MESH: Tumor Necrosis Factor-alpha, MESH: Administration, Oral, MESH: C-Reactive Protein, MESH: Double-Blind Method, MESH: Coronary Disease, MESH: Estradiol, MESH: Female, MESH: Postmenopause, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: Treatment Outcome
Abstract

International audience; C-reactive protein (CRP) is one of the main independent predictors of cardiovascular events. Oral post-menopausal estrogen replacement therapy (ERT) increases CRP levels, but the effect of transdermal ERT is not well documented. CRP, interleukine-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels were evaluated in a randomised study of 196 healthy postmenopausal women, who were allocated to receive continuous oral estradiol-1beta, (n=63) or transdermal estradiol-1beta, (n=68) both combined with micronised progesterone, or place-bo (n=65). Oral estrogen increased CRP levels compared with both placebo (p=0.010) and transdermal estrogen (p=0.004) at 6 months. There was no significant effect of transdermal estrogen on CRP levels compared with placebo (p=0.997). No significant difference was found in the median changes for IL-6 and TNF-alpha between the three treatment groups. In conclusion, transdermal estrogen has no significant effect on CRP levels at 6 months, but CRP concentrations increased significantly with oral estrogen although no changes in cytokine levels were detected. The clinical relevance of these effects remains to be determined.

95. Management of anti-vitamin K overdose, situations at hemorrhagic risk and hemorrhagic accidents among patients treated with anti-vitamin K in urban and hospital setting: Introduction,Prise en charge des surdosages en antivitamines K, des situations à risque hémorrahique et des accidents hémorragiques chez les patients traités par antivitamines K en ville et en milieu hospitalier: Introduction

Author

Pierre SIE, Bouget, J., Boulain, T., Castot, A., Dumarcet, N., Druais, P. -L, Gruel, Y., Helf, G., Huas, D., Iung, B., Laroche, J. -P, Leger, P., Mahe, I., Pelladeau, A., Roy, P. -M, Samama, C. M., Pernod, G., Godier, A., Gozalo, C., Tremey, B., Blanchard, P., Albaladejo, P., D Azemar, P., Beirut, G., Bosson, J. -L, Calvel, L., Carteaux, J. -P, Couturaud, F., Riberolles, C., Drouet, L., Faugère, C., Ferrari, E., Gaussem, P., Gervais, C., Haramburu, F., Hay, B., Ickx, B., Jego, P., Lapostole, F., Lasne, D., Le Gal, G., Lecompte, T., Long, A., Marret, E., May, M. -A, Meyer, G., Montagne, O., Motte, S., Nozieres, E., Parent, F., Pautas, E., Rey-Quino, C., Riché, C., Siguret, V., Steib, A., Susen, S., Tazarourte, K., Vigué, B., Ajzenberg, N., Andrejak, M., Audibert, G., Bergmann, J. -F, Blais, N., Bruder, N., Bura-Riviére, A., Cariou, A., Cazalets, C., Colombani, J. -C, Moerloose, P., Debray, M., Fabre, R., Fauvel, J. -M, Fernandez, S., Fourrier, F., Girard, P., Gouin-Thibault, I., Guillet, B., Horellou, M. -H, Hurtaud-Roux, M. -F, Janvier, G., Lacroix, P., Lacut, K., Lamy, C., Laporte, S., Le Cam-Duchez, V., Legras, A., Mismetti, P., Moinard, P., Montalescot, G., Nguyen, P., Nicodème, R., Pinel, J. -F, Piriou, V., Roudot, R., Schved, J. -F, Sellin, M., Toussaint-Hacquard, M., Vincentelli, A., and Wahl, D.

96. Management of anti-vitamin K overdose, situations at hemorrhagic risk and hemorrhagic accidents among patients treated with anti-vitamin K in urban and hospital setting: Introduction | Prise en charge des surdosages en antivitamines K, des situations à risque hémorrahique et des accidents hémorragiques chez les patients traités par antivitamines K en ville et en milieu hospitalier: Introduction

Author

Ajzenberg, N., Albaladejo, P., Andrejak, M., Audibert, G., Beirut, G., Bergmann, J. -F, Blais, N., Blanchard, P., Bosson, J. -L, Bouget, J., Boulain, T., Bruder, N., Bura-Riviére, A., Calvel, L., Cariou, A., Carteaux, J. -P, Castot, A., Cazalets, C., Colombani, J. -C, Couturaud, F., D Azemar, P., Moerloose, P., Riberolles, C., Debray, M., Drouet, L., Druais, P. -L, Dumarcet, N., Fabre, R., Faugère, C., Fauvel, J. -M, Fernandez, S., Ferrari, E., Fourrier, F., Gaussem, P., Gervais, C., Girard, P., Godier, A., Gouin-Thibault, I., Gozalo, C., Gruel, Y., Guillet, B., Haramburu, F., Hay, B., Helf, G., Horellou, M. -H, Huas, D., Hurtaud-Roux, M. -F, Ickx, B., Iung, B., Janvier, G., Jego, P., Lacroix, P., Lacut, K., Lamy, C., Laporte, S., Lapostole, F., Laroche, J. -P, Lasne, D., Le Cam-Duchez, V., Grégoire LE GAL, Lecompte, T., Leger, P., Legras, A., Long, A., Mahe, I., Marret, E., May, M. -A, Meyer, G., Mismetti, P., Moinard, P., Montagne, O., Montalescot, G., Motte, S., Nguyen, P., Nicodème, R., Nozieres, E., Parent, F., Pautas, E., Pelladeau, A., Pernod, G., Pinel, J. -F, Piriou, V., Rey-Quino, C., Riché, C., Roudot, R., Roy, P. -M, Samama, C. M., Schved, J. -F, Sellin, M., Siguret, V., Sié, P., Steib, A., Susen, S., Tazarourte, K., Toussaint-Hacquard, M., Tremey, B., Vigué, B., Vincentelli, A., and Wahl, D.

98. Antipsychotics: A Real or Confounding Risk Factor for Venous Thromboembolism?

Author

Chapelle, C., Quenet, S., Delavenne, X., Lacut, K., Mismetti, P., Laporte, S., and Beyens, M. N.

Subjects
ANTIPSYCHOTIC agents, DRUG therapy for psychoses, PSYCHIATRIC drugs, THROMBOEMBOLISM, THROMBOSIS
Abstract

In a meta-analysis of case-control studies, Zhang et al. (2011) found an increased risk of venous thromboembolic events (VTE) in patients exposed to antipsychotics (OR = 2.39 [1.71-3.35]). Our updated meta-analysis including the 2 available cohort studies, recognized as a more relevant type of observational study, showed a weaker, but still strong association (OR = 1.84 [1.39; 2.44]). In view of the lack of data on the confirmed risk factors for VTE in existing studies, prospective studies including adjustment for these risk factors are warranted to confirm this association and to assess the benefit/risk ratio of antipsychotics in high-risk patients. [ABSTRACT FROM AUTHOR]

Published
2013
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100. Heart Rate and Mortality in Patients With Acute Symptomatic Pulmonary Embolism

Author

G. Pellejero, Jose Gutierrez, R. Malý, M. Basaglia, L. Chasco, P. Suchon, R. Le Mao, Laurent Bertoletti, F. Martins, J. Caprini, A. Braester, F. Galeano-Valle, Hanh My Bui, J. Alonso, Y. Sato, G. Vidal, Y. Nishimoto, C. Tolosa, E. Nofuentes-Pérez, A.M. Díaz-Brasero, N. Ait Abdallah, M.D. Adarraga, R. Sánchez-Martínez, L. Font, Raquel López-Reyes, Inna Tzoran, Karine Lacut, J. del Toro, Andris Skride, Ana Jaureguizar, Joseph A. Caprini, C. Amado, R. García de la Garza, A.M. Camon, S. Merla, Luciano López-Jiménez, G. Salgueiro, Sebastian Schellong, Alfonso Muriel, F. Bilora, S. Lainez-Justo, B. Suárez-Rodríguez, Carme Font, F. Beddar Chaib, I. Francisco, C. Jiménez-Alfaro, P. Azcarate-Agüero, Maurizio Ciammaichella, J.A. Porras, N. Vo Hong, F. Martín-Martos, Dominique Farge-Bancel, D. Farge-Bancel, José Luis Lobo, M. Giménez-Suau, E. Grau, F. García-Bragado, Ángeles Blanco-Molina, Carmen Fernández-Capitán, María del Carmen Díaz-Pedroche, C. Grange, Adriana Visonà, L. Guirado, P. Villares, P. López-Miguel, José María Pedrajas, S. Accassat, Beatriz Valero, B. Crichi, Juan J. López-Núñez, Luis Jara-Palomares, G. Sarlon-Bartoli, J. Lima, C. Bortoluzzi, Alicia Lorenzo, C. de Ancos, M.A. Fidalgo, Philippe Debourdeau, Pablo Javier Marchena, C. Rodríguez-Matute, A.I. Farfán-Sedano, José Luis Fernández-Reyes, J.C. Escribano, Juan I. Arcelus, M. Barrón, I. Quere, Remedios Otero, A. De Angelis, P. Morange, Peter Verhamme, G. Kenet, P. Prandoni, Pedro Ruiz-Artacho, C. Siniscalchi, A. Zaicenko, M. Olid-Velilla, C. García-Díaz, B. Barrón-Andrés, T. Sancho, Fernando Uresandi, Javier Trujillo-Santos, A. Muñoz-Blanco, A. Villalobos, A. Dubois-Silva, J. Moisés, J. Osorio, M.I. Mercado, J.M. Suriñach, M.A. Aibar, M.D. Joya, Cihan Ay, J.A. Díaz-Peromingo, H. Bounameaux, Diego Martínez-Urbistondo, Thomas Vanassche, L. Bertoletti, Marijan Bosevski, Farès Moustafa, M. Martín del Pozo, J.F. Sánchez-Muñoz-Torrero, H.M. Bui, Ingrid Pabinger, M.C. Olivares, M. García de Herreros, M.J. Núñez-Fernández, B. Zalunardo, J.F. Varona, Stephan Nopp, Behnood Bikdeli, B. Brandolin, B. Bikdeli, Olga Madridano, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, Abílio Reis, J. Portillo, O. Espitia, J. Catella, Aitor Ballaz, F. Esposito, R. Barba, R. Valle, H. Helfer, I. Tzoran, J.B. López-Sáez, P. Ruiz-Artacho, M.A. García, J. Aibar, C. Gómez-Cuervo, C. Gabara, A. Latorre, J. Ruiz-Ruiz, Benjamin Brenner, S. Fonseca, S. Schellong, Raffaele Pesavento, Barry M. Brenner, Silvia Soler, Paolo Prandoni, Victor F. Tapson, Ana Maestre, Pierpaolo Di Micco, M. Muñoz, J. Criado, D. Jiménez, Antonella Tufano, G. Krstevski, B. Valero, Henri Bounameaux, M.I. Torres, G. Poenou, Isabelle Mahé, Aída Gil-Díaz, A. Asuero, S. Otalora, V. Rosa, L. Vela, E. Imbalzano, C. Vandenbriele, C. Barbagelata, Jana Hirmerova, J. Meireles, David Jiménez, Lucia Mazzolai, L. Hernández-Blasco, M. Bosevski, Gili Kenet, C. Mella, M. Monreal, J.R. Vela, P. Di Micco, Carlos Zamora, K. Flores, P. Demelo-Rodríguez, Radovan Malý, J. Birzulis, J.A. Nieto, J. Castro, M.V. Di Campli, Francis Couturaud, Raquel Barba, Jaureguizar, A., Jimenez, D., Bikdeli, B., Ruiz-Artacho, P., Muriel, A., Tapson, V., Lopez-Reyes, R., Valero, B., Kenet, G., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Maly, R., Verhamme, P., Caprini, J. A., Bui, H. M., Adarraga, M. D., Aibar, J., Aibar, M. A., Alonso, J., Amado, C., Arcelus, J. I., Asuero, A., Azcarate-Aguero, P., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Beddar Chaib, F., Camon, A. M., Castro, J., Chasco, L., Criado, J., de Ancos, C., del Toro, J., Demelo-Rodriguez, P., Diaz-Brasero, A. M., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Di Campli, M. V., Dubois-Silva, A., Escribano, J. C., Esposito, F., Farfan-Sedano, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Font, L., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia de Herreros, M., Garcia de la Garza, R., Garcia-Diaz, C., Gil-Diaz, A., Gomez-Cuervo, C., Gimenez-Suau, M., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Jimenez-Alfaro, C., Joya, M. D., Lainez-Justo, S., Latorre, A., Lima, J., Lobo, J. L., Lopez-Jimenez, L., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Saez, J. B., Lorenzo, A., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Urbistondo, D., Mella, C., Mercado, M. I., Moises, J., Munoz, M., Munoz-Blanco, A., Nieto, J. A., Nofuentes-Perez, E., Nunez-Fernandez, M. J., Olid-Velilla, M., Olivares, M. C., Osorio, J., Otalora, S., Otero, R., Pedrajas, J. M., Pellejero, G., Porras, J. A., Portillo, J., Rodriguez-Matute, C., Rosa, V., Ruiz-Ruiz, J., Salgueiro, G., Sanchez-Martinez, R., Sanchez-Munoz-Torrero, J. F., Sancho, T., Soler, S., Suarez-Rodriguez, B., Surinach, J. M., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Valle, R., Varona, J. F., Vela, L., Vela, J. R., Vidal, G., Villalobos, A., Villares, P., Zamora, C., Ay, C., Nopp, S., Pabinger, I., Vanassche, T., Vandenbriele, C., Hirmerova, J., Accassat, S., Ait Abdallah, N., Bura-Riviere, A., Catella, J., Couturaud, F., Crichi, B., Debourdeau, P., Espitia, O., Grange, C., Helfer, H., Lacut, K., Le Mao, R., Mahe, I., Morange, P., Moustafa, F., Poenou, G., Sarlon-Bartoli, G., Suchon, P., Quere, I., Braester, A., Basaglia, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., De Angelis, A., Imbalzano, E., Merla, S., Pesavento, R., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Nishimoto, Y., Sato, Y., Birzulis, J., Skride, A., Zaicenko, A., Fonseca, S., Martins, F., Meireles, J., Krstevski, G., and Mazzolai, L.

Subjects
Male, Registrie, Pulmonary and Respiratory Medicine, medicine.medical_specialty, pulmonary embolism, Critical Care and Intensive Care Medicine, Logistic regression, Heart Rate, Internal medicine, Heart rate, medicine, In patient, Aged, Aged, 80 and over, business.industry, medicine.disease, mortality, Pulmonary embolism, Prospective Studie, Increased risk, Spain, Cardiology, Positive relationship, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Background: The association between heart rate (HR) and pulmonary embolism (PE) outcomes has not been well studied. Furthermore, optimal cutoffs to identify low-risk and intermediate- to high-risk patients are not well known. Research Question: Does an association exist between baseline HR and PE outcome across the continuum of HR values? Study Design and Methods: The current study included 44,331 consecutive nonhypotensive patients with symptomatic PE from the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2021. Outcomes included 30-day all-cause and PE-specific mortality. We used hierarchical logistic regression to assess the association between admission HR and outcomes. Results: A positive relationship was found between admission HR and 30-day all-cause and PE-related mortality. Considering an HR of 80 to 99 beats/min as a reference, patients in the higher HR strata showed higher rates of all-cause death (adjusted OR, 1.5 for HR of 100-109 beats/min; adjusted OR, 1.7 for HR of 110-119 beats/min; adjusted OR, 1.9 for HR of 120-139 beats/min; and adjusted OR, 2.4 for HR of ≥ 140 beats/min). Patients in the lower strata of HR showed significantly lower rates of 30-day all-cause mortality compared with the same reference group (adjusted OR, 0.6 for HR of 60-79 beats/min; and adjusted OR, 0.5 for HR of < 60 beats/min). The findings for 30-day PE-related mortality were similar. For identification of low-risk patients, a cutoff value of 80 beats/min (vs 110 beats/min) increased the sensitivity of the simplified Pulmonary Embolism Severity Index (sPESI) from 93.4% to 98.8%. For identification of intermediate- to high-risk patients, a cutoff value of 140 beats/min (vs 110 beats/min) increased the specificity of the Bova score from 93.2% to 98.0%. Interpretation: In nonhypotensive patients with acute symptomatic PE, a high HR portends an increased risk of all-cause and PE-related mortality. Modifying the HR cutoff in the sPESI and the Bova score improves prognostication of patients with PE.

Published
2022

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