Search

Your search keyword '"Conget, F."' showing total 50 results
Start Over Author "Conget, F."
50 results on '"Conget, F."'

1. A RIETE registry analysis of recurrent thromboembolism and hemorrhage in patients with catheter-related thrombosis

Author

Monreal, Manuel, Decousus, Hervè, Prandoni, Paolo, Brenner, Benjamin, Barba, Raquel, Di Micco, Pierpaolo, Bertoletti, Laurent, Schellong, Sebastian, Tzoran, Inna, Reis, Abilio, Bosevski, Marijan, Bounameaux, Henri, Malý, Radovan, Wells, Philip, Alcalde, M., Alibalic, A., Arcelus, J.I., Auguet, T., Barba, R., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Benítez, J.F., Blanco-Molina, A., Casado, I., Conget, F., del Molino, F., del Toro, J., Díaz, J.A., Falgá, C., Fernández-Capitán, C., Font, L., Gallego, P., García-Bragado, F., García, A., Gómez-Durán, M., Gómez, V., González, J., Grau, E., Guijarro, R., Gutiérrez, J., Hernández, L., Hernández-Huerta, S., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jiménez, R., Jiménez, S., Lecumberri, R., Lobo, J.L., López-Jiménez, L., López-Montes, L., López-Reyes, R., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Macià, M., Madridano, O., Marchena, P.J., Martín-Antorán, J.M., Martín-Martos, F., Monreal, M., Morales, M.V., Muñoz, F.J., Nauffal, D., Nieto, J.A., Núñez, M.J., Otero, R., Pagán, B., Pedrajas, J.M., Pérez-Rus, G., Peris, M.L., Pons, I., Porras, J.A., Riera-Mestre, A., Rivas, A., Rodríguez-Dávila, M.A., Román, P., Rosa, V., Ruiz-Giménez, N., Sabio, P., Sampériz, A., Sánchez, R., Sanz, O., Soler, S., Sopeña, B., Soto, M.J., Suriñach, J.M., Tiberio, G., Tirado, R., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Vilella-Tomas, V., Villalobos, A., Villalta, J., Malfante, P., Verhamme, P., Vanassche, T., Wells, P., Malý, R., Hirmerova, J., Bertoletti, L., Bura-Riviere, A., Moustafa, F., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Quere, I., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Apollonio, A., Barillari, G., Ciammaichella, M., Valle, F., Di Micco, P., Ferrazzi, P., Guida, A., Maida, R., Pace, F., Pasca, S., Piovella, C., Prandoni, P., Re, R., Rota, L., Tonello, D., Tufano, A., Visonà, A., Zalunardo, B., Malheiro, J., Ribeiro, J.L., Sousa, M.S., Bosevski, M., Zdraveska, M., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., Caprini, J., Serrano, J.C., Baumann Kreuziger, Lisa, Cote, Lauren, Verhamme, Peter, Greenberg, Steven, Caprini, Joseph, Muñoz, Francisco José, Valle, Reina, and Monreal Bosch, Manuel

Published
2015
Full Text
View/download PDF

2. A Prognostic Score to Identify Low-risk Outpatients with Acute Deep Vein Thrombosis in the Lower Limbs

Author

Adarraga, M.D., Alcalde, M., Andújar, V., Arcelus, J.I., Barba, R., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Blanco-Molina, A., Bueso, T., Casado, I., Climent, A., Conget, F., del Molino, F., del Toro, J., Falgá, C., Fernández-Capitán, C., Font, L., Gallego, P., García-Bragado, F., Gómez, V., González, J., González-Bachs, E., Grau, E., Guijarro, R., Guil, M., Gutiérrez, J., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jiménez, R., Lecumberri, R., Lobo, J.L., López-Jiménez, L., López-Montes, L., López-Reyes, R., López-Sáez, J.B., Lorente, M.A., Lorenzo, A., Luque, J.M., Madridano, O., Marchena, P.J., Martín-Antorán, J.M., Mellado, M., Monreal, M., Morales, M.V., Nauffal, D., Nieto, J.A., Núñez, M.J., Ogea, J.L., Otero, R., Pagán, B., Pedrajas, J.M., Pérez-Rus, G., Peris, M.L., Porras, J.A., Pons, I., Riera-Mestre, A., Rivas, A., Rodríguez-Dávila, M.A., Román, P., Rosa, V., Ruiz-Giménez, N., Ruiz, J., Sabio, P., Samperiz, A., Sánchez, R., Soler, S., Suriñach, J.M., Tiberio, G., Trujillo-Santos, J., Uresandi, F., Valero, B., Valle, R., Vela, J., Villalobos, A., Malfante, P., Verhamme, P., Peerlinck, K., Wells, P., Malý, R., Hirmerova, J., Kaletova, M., Tomko, T., Bertoletti, L., Bura-Riviere, A., Farès, M., Grange, C., Mahe, I., Merah, A., Quere, I., Schellong, S., Papadakis, M., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Apollonio, A., Barillari, G., Ciammaichella, M., Di Micco, 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., Visonà, A., Zalunardo, B., Almeida, S., Leal-Seabra, F., Sousa, M.S., Bosevski, M., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., Serrano, J.C., Trujillo-Santos, Javier, Lozano, Francisco, Lorente, Manuel Alejandro, Adarraga, Dolores, Hirmerova, Jana, Del Toro, Jorge, Mazzolai, Lucia, Barillari, Giovanni, Barrón, Manuel, and Monreal, Manuel

Published
2015
Full Text
View/download PDF

4. 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
Full Text
View/download PDF

5. 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
Full Text
View/download PDF

6. 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
Full Text
View/download PDF

7. 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
Full Text
View/download PDF

8. 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

9. 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

10. 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
Full Text
View/download PDF

11. 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
Full Text
View/download PDF

12. 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
Full Text
View/download PDF

13. 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
Full Text
View/download PDF

14. Venous thromboembolism in patients immobilised at home

Author

Lopez-Reyes, R., Nauffal, D., Ballester, M., Martin-Antoran, J. M., Saraiva De Sousa, M., Riera-Mestre, A., Ruiz-Ruiz, J., Fernandez-Capitan, C., Uresandi, F., Monreal, M., Alcalde-Manero, M., Andutejar, V., Arcelus, J. I., Barba, R., Barron, M., Barron-Andres, B., Bascunana, J., Blanco-Molina, A., Casado, I., Conget, F., De Ancos, C., Del Molino, F., Del Toro, J., Diaz, J. A., Falga, C., Farfan, A. I., Font, C., Font, L., Gallego, P., Garcia-Bragado, F., Gomez, V., Gonzalez, J., Gonzlez-Marcano, D., Grau, E., Guijarro, R., Gutierrez, J., Hernandez, L., Hernandez-Huerta, S., Jara-Palomares, L., Jaras, M. J., Jimenez, D., Lobo, J. L., Lopez-Jimenez, L., Lopez-Montes, L., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Maci, M., Madridano, O., Marchena, P. J., Martin-Martos, F., Mellado, M., Morales, M. V., Nieto, J. A., Nunez, M. J., Otero, R., Pagan, B., Pedrajas, J. M., Perez-Rus, G., Peris, M. L., Pons, I., Porras, J. A., Rivas, A., Rodriguez-Davila, M. A., Roman, P., Rosa, V., Ruiz-Gimenez, N., Ruiz, J., Samperiz, A., Sanchez, R., Sanz, O., Soler, S., Surinach, J. M., Tiberio, G., Tirado, R., Trujillo-Santos, J., Valero, B., Valle, R., Vela, J., Vilar, C., Villalobos, A., Villalta, J., Malfante, P., Verhamme, P., Vanassche, T., Gadelha, T., Wells, P., Maly, R., Hirmerova, J., Bertoletti, L., Bura-Riviere, A., Moustafa, F., Farge-Bancel, D., Hij, A., Mahe, I., Merah, A., Quere, I., Schellong, S., Braester, A., Brenner, B., Tzoran, I., Zeltser, D., Apollonio, A., Barillari, G., Ciammaichella, M., Dalla Valle, F., Di Micco, P., Ferrazzi, P., Guida, A., Maida, R., Pace, F., Pasca, S., Piovella, C., Prandoni, P., Re, R., Rota, L., Tiraferri, E., Tonello, D., Tufano, A., Visona, A., Zalunardo, B., Mondragao, A., Sousa, M. S., Bosevski, M., Zdraveska, M., Alatri, A., Bounameaux, H., Calanca, L., Mazzolai, L., and Serrano, J. C.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Multivariate analysis, MEDLINE, Chemoprevention, Immobilization, Ambulatory care, Fibrinolytic Agents, Environmental health, medicine, Ambulatory Care, Humans, natural sciences, In patient, Registries, business.industry, Venous Thromboembolism, medicine.disease, 3. Good health, Pulmonary embolism, Hospitalization, Logistic Models, Emergency medicine, Multivariate Analysis, Pulmonary Embolism, business, Venous thromboembolism, Fibrinolytic agent
Abstract

Fatal PE after immobility at home was more frequent than after immobility in hospital http://ow.ly/J0UIr

Published
2014

15. 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

16. National Consensus on the Diagnosis, Risk Stratification and Treatment of Patients with Pulmonary Embolism. Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Society Española Internal Medicine (SEMI). Spanish Society of Thrombosis and Haemostasis (SETH). Spanish Society of Cardiology (ESC). Spanish Society of Medicine Accident and Emergency (SEMES). Spanish Society of Angiology and Surgery Vascular (SEACV)

Author

Uresandi F, Monreal M, García-Bragado F, Domenech P, Lecumberri R, Escribano P, Zamorano JL, Jiménez S, Ruiz-Artacho P, Lozano F, Romera A, Jiménez D, National Consensus on Diagnosis, Risk Stratification and Treatment of Patients W, Bellmunt S, Cuenca J, Fernández Á, Fernández F, Ibáñez V, March JR, Almenar L, Castro A, Lázaro M, Luis Zamorano J, Alonso JR, Ramón Casal J, Miguel Franco J, Merlo M, Perales R, Piñera P, Suero C, Barba R, Fernández-Capitán C, Gómez V, Nieto JA, Riera-Mestre A, Suárez C, Trujillo-Santos J, Conget F, Jara L, Lobo JL, de Miguel J, Nauffal D, Oribe M, Otero R, González-Porras JR, Llamas P, Mingot E, Pina E, Rodríguez-Martorell J, and Society Española Internal Medicine (SEMI)

Published
2013

17. 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

18. 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

19. 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

20. 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

21. 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

22. A RIETE registry analysis of recurrent thromboembolism and hemorrhage in patients with catheter-related thrombosis

Author

Baumann Kreuziger, Lisa, primary, Cote, Lauren, additional, Verhamme, Peter, additional, Greenberg, Steven, additional, Caprini, Joseph, additional, Muñoz, Francisco José, additional, Valle, Reina, additional, Monreal Bosch, Manuel, additional, Monreal, Manuel, additional, Decousus, Hervè, additional, Prandoni, Paolo, additional, Brenner, Benjamin, additional, Barba, Raquel, additional, Di Micco, Pierpaolo, additional, Bertoletti, Laurent, additional, Schellong, Sebastian, additional, Tzoran, Inna, additional, Reis, Abilio, additional, Bosevski, Marijan, additional, Bounameaux, Henri, additional, Malý, Radovan, additional, Wells, Philip, additional, Alcalde, M., additional, Alibalic, A., additional, Arcelus, J.I., additional, Auguet, T., additional, Barba, R., additional, Barrón, M., additional, Barrón-Andrés, B., additional, Bascuñana, J., additional, Benítez, J.F., additional, Blanco-Molina, A., additional, Casado, I., additional, Conget, F., additional, del Molino, F., additional, del Toro, J., additional, Díaz, J.A., additional, Falgá, C., additional, Fernández-Capitán, C., additional, Font, L., additional, Gallego, P., additional, García-Bragado, F., additional, García, A., additional, Gómez-Durán, M., additional, Gómez, V., additional, González, J., additional, Grau, E., additional, Guijarro, R., additional, Gutiérrez, J., additional, Hernández, L., additional, Hernández-Huerta, S., additional, Jara-Palomares, L., additional, Jaras, M.J., additional, Jiménez, D., additional, Jiménez, R., additional, Jiménez, S., additional, Lecumberri, R., additional, Lobo, J.L., additional, López-Jiménez, L., additional, López-Montes, L., additional, López-Reyes, R., additional, López-Sáez, J.B., additional, Lorente, M.A., additional, Lorenzo, A., additional, Macià, M., additional, Madridano, O., additional, Marchena, P.J., additional, Martín-Antorán, J.M., additional, Martín-Martos, F., additional, Monreal, M., additional, Morales, M.V., additional, Muñoz, F.J., additional, Nauffal, D., additional, Nieto, J.A., additional, Núñez, M.J., additional, Otero, R., additional, Pagán, B., additional, Pedrajas, J.M., additional, Pérez-Rus, G., additional, Peris, M.L., additional, Pons, I., additional, Porras, J.A., additional, Riera-Mestre, A., additional, Rivas, A., additional, Rodríguez-Dávila, M.A., additional, Román, P., additional, Rosa, V., additional, Ruiz-Giménez, N., additional, Sabio, P., additional, Sampériz, A., additional, Sánchez, R., additional, Sanz, O., additional, Soler, S., additional, Sopeña, B., additional, Soto, M.J., additional, Suriñach, J.M., additional, Tiberio, G., additional, Tirado, R., additional, Trujillo-Santos, J., additional, Uresandi, F., additional, Valero, B., additional, Valle, R., additional, Vela, J., additional, Vilella-Tomas, V., additional, Villalobos, A., additional, Villalta, J., additional, Malfante, P., additional, Verhamme, P., additional, Vanassche, T., additional, Wells, P., additional, Malý, R., additional, Hirmerova, J., additional, Bertoletti, L., additional, Bura-Riviere, A., additional, Moustafa, F., additional, Farge-Bancel, D., additional, Hij, A., additional, Mahe, I., additional, Merah, A., additional, Quere, I., additional, Schellong, S., additional, Braester, A., additional, Brenner, B., additional, Tzoran, I., additional, Apollonio, A., additional, Barillari, G., additional, Ciammaichella, M., additional, Valle, F., additional, Di Micco, P., additional, Ferrazzi, P., additional, Guida, A., additional, Maida, R., additional, Pace, F., additional, Pasca, S., additional, Piovella, C., additional, Prandoni, P., additional, Re, R., additional, Rota, L., additional, Tonello, D., additional, Tufano, A., additional, Visonà, A., additional, Zalunardo, B., additional, Malheiro, J., additional, Ribeiro, J.L., additional, Sousa, M.S., additional, Bosevski, M., additional, Zdraveska, M., additional, Alatri, A., additional, Bounameaux, H., additional, Calanca, L., additional, Mazzolai, L., additional, Caprini, J., additional, and Serrano, J.C., additional

Published
2015
Full Text
View/download PDF

23. A Prognostic Score to Identify Low-risk Outpatients with Acute Deep Vein Thrombosis in the Lower Limbs

Author

Trujillo-Santos, Javier, primary, Lozano, Francisco, additional, Lorente, Manuel Alejandro, additional, Adarraga, Dolores, additional, Hirmerova, Jana, additional, Del Toro, Jorge, additional, Mazzolai, Lucia, additional, Barillari, Giovanni, additional, Barrón, Manuel, additional, Monreal, Manuel, additional, Adarraga, M.D., additional, Alcalde, M., additional, Andújar, V., additional, Arcelus, J.I., additional, Barba, R., additional, Barrón, M., additional, Barrón-Andrés, B., additional, Bascuñana, J., additional, Blanco-Molina, A., additional, Bueso, T., additional, Casado, I., additional, Climent, A., additional, Conget, F., additional, del Molino, F., additional, del Toro, J., additional, Falgá, C., additional, Fernández-Capitán, C., additional, Font, L., additional, Gallego, P., additional, García-Bragado, F., additional, Gómez, V., additional, González, J., additional, González-Bachs, E., additional, Grau, E., additional, Guijarro, R., additional, Guil, M., additional, Gutiérrez, J., additional, Jara-Palomares, L., additional, Jaras, M.J., additional, Jiménez, D., additional, Jiménez, R., additional, Lecumberri, R., additional, Lobo, J.L., additional, López-Jiménez, L., additional, López-Montes, L., additional, López-Reyes, R., additional, López-Sáez, J.B., additional, Lorente, M.A., additional, Lorenzo, A., additional, Luque, J.M., additional, Madridano, O., additional, Marchena, P.J., additional, Martín-Antorán, J.M., additional, Mellado, M., additional, Monreal, M., additional, Morales, M.V., additional, Nauffal, D., additional, Nieto, J.A., additional, Núñez, M.J., additional, Ogea, J.L., additional, Otero, R., additional, Pagán, B., additional, Pedrajas, J.M., additional, Pérez-Rus, G., additional, Peris, M.L., additional, Porras, J.A., additional, Pons, I., additional, Riera-Mestre, A., additional, Rivas, A., additional, Rodríguez-Dávila, M.A., additional, Román, P., additional, Rosa, V., additional, Ruiz-Giménez, N., additional, Ruiz, J., additional, Sabio, P., additional, Samperiz, A., additional, Sánchez, R., additional, Soler, S., additional, Suriñach, J.M., additional, Tiberio, G., additional, Trujillo-Santos, J., additional, Uresandi, F., additional, Valero, B., additional, Valle, R., additional, Vela, J., additional, Villalobos, A., additional, Malfante, P., additional, Verhamme, P., additional, Peerlinck, K., additional, Wells, P., additional, Malý, R., additional, Hirmerova, J., additional, Kaletova, M., additional, Tomko, T., additional, Bertoletti, L., additional, Bura-Riviere, A., additional, Farès, M., additional, Grange, C., additional, Mahe, I., additional, Merah, A., additional, Quere, I., additional, Schellong, S., additional, Papadakis, M., additional, Braester, A., additional, Brenner, B., additional, Tzoran, I., additional, Zeltser, D., additional, Apollonio, A., additional, Barillari, G., additional, Ciammaichella, M., additional, Di Micco, P., additional, Duce, R., additional, Guida, A., additional, Maida, R., additional, Pace, F., additional, Pasca, S., additional, Piovella, C., additional, Pesavento, R., additional, Poggio, R., additional, Prandoni, P., additional, Rota, L., additional, Tiraferri, E., additional, Tonello, D., additional, Tufano, A., additional, Visonà, A., additional, Zalunardo, B., additional, Almeida, S., additional, Leal-Seabra, F., additional, Sousa, M.S., additional, Bosevski, M., additional, Alatri, A., additional, Bounameaux, H., additional, Calanca, L., additional, Mazzolai, L., additional, and Serrano, J.C., additional

Published
2015
Full Text
View/download PDF

24. C0246: Quality of Life in Acute Symptomatic Pulmonary Embolism and Low-Risk Prognosis

Author

Morillo-Guerrero, R., primary, Jara-Palomares, L., additional, Uresandi, F., additional, Jimenez, D., additional, Angel Cabezudo, M., additional, Oribe, M., additional, Nauffal, D., additional, Conget, F., additional, Rodriguez-Matute, C., additional, Cayuela, A., additional, Sanchez-Oro-Gomez, R., additional, Ferrer-Galvan, M., additional, Elias-Hernández, T., additional, Isabel Asencio, M., additional, and Otero-Candelera, R., additional

Published
2014
Full Text
View/download PDF

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

Author

Universitat Rovira i Virgili, Bertoletti L, Quenet S, Laporte S, Sahuquillo JC, Conget F, Pedrajas JM, Martin M, Casado I, Riera-Mestre A, Monreal M, RIETE Investigators, Universitat Rovira i Virgili, and Bertoletti L, Quenet S, Laporte S, Sahuquillo JC, Conget F, Pedrajas JM, Martin M, Casado I, Riera-Mestre A, Monreal M, RIETE Investigators

Abstract

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.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)).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).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.

Published
2013

29. Clinical syndromes and clinical outcome in patients with pulmonary embolism: findings from the RIETE registry.

Author

Lobo JL, Zorrilla V, Aizpuru F, Uresandi F, Garcia-Bragado F, Conget F, and Monreal M

Abstract

INTRODUCTION: The influence of the clinical syndromes of pulmonary embolism (PE) on clinical outcome has not been evaluated. PATIENTS AND METHODS: The Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) is an ongoing registry of consecutive patients with acute venous thromboembolism. In this study, all enrolled patients with acute PE without preexisting cardiac or pulmonary disease were classified into three clinical syndromes: pulmonary infarction, isolated dyspnea, or circulatory collapse. Their clinical characteristics, laboratory findings, and 3-month outcomes were compared. RESULTS: As of January 2005, 4,145 patients with acute, symptomatic, objectively confirmed PE have been enrolled in RIETE. Of them, 3,391 patients (82%) had no chronic lung disease or heart failure: 1,709 patients (50%) had pulmonary infarction, 1,083 patients (32%) had isolated dyspnea, and 599 patients (18%) had circulatory collapse. Overall, 149 patients (4.4%) died during the first 15 days of therapy: 2.5% with pulmonary infarction, 6.2% with isolated dyspnea (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.7 to 3.8), and 6.5% with circulatory collapse (OR, 2.7; 95% CI, 1.7 to 4.2). From days 16 to 90, 31 patients had recurrent PE; 5 of 14 patients (36%) with pulmonary infarction died of their new PE, compared with 5 of 10 patients (50%) with isolated dyspnea, and all 7 patients (100%) with circulatory collapse. CONCLUSIONS: PE patients with pulmonary infarction (50% of the whole series) had a significantly lower mortality rate both during initial therapy and after discharge. [ABSTRACT FROM AUTHOR]

Published
2006
Full Text
View/download PDF

31. Venous thromboembolism in very elderly patients: findings from a prospective registry (RIETE)

Author

Lopez-Jimenez, Luciano, Montero, Manuel, Antonio Gonzalez-Fajardo, Jose, Ignacio Arcelus, Juan, Suarez, Carmen, Luis Lobo, Jose, Monreal, Manuel, Alvarez, J. C., Arcelus, J., Barba, R., Barron, M., Blanco, A., Beato, J. L., Bosco, J., Buges, J., Calvo, J. M., Candel, I., Canas, I., Casado, I., Conget, F., Epelde, F., Falga, C., Fernandez, C., Gabriel, F., Gallego, P., Garcia, M. D., Garcia Bragado, F., Grau, A., Grau, E., Gonzalez, M. A., Gonzalez-Fajardo, A., Guijarro, R., Guil, M., Gutierrez, J., Gutierrez, M. R., Las Heras, G., Hernandez, L., Herrera, S., Jimenez, D., Laserna, E., Lecumberri, R., Lobo, J. L., Lopez, F., Lopez, I., Lopez, L., Maestre, A., Martin, J. J., Monreal, M., Montes, J., Naufall, D., Nieto, J. A., Nunez, M. J., Orue, M. T., Remedios Otero-Candelera, Page, M. A., Pedrajas, J. M., Perez-Burkhardt, J. L., Portillo, J., Rabunal, R., Raguer, E., Raventos, A., Del Rio, M. C., Rivero, M., Roman, P., Romero, C., Rondon, P., Rosa, V., Samperiz, A. L., Sanchez, A., Sanchez, J. F., Sanchez, R., Soler, S., Soto, M. J., Suarez, C., Tiberio, G., Tirado, R., Todoli, J. A., Tolosa, C., Del Toro, J., Torre, J. A., Trujillo-Santos, J., Uresandi, F., Valle, R., Vasco, B., Guillot, K., Mismetti, P., and Llobet, X.

39. 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
Full Text
View/download PDF

40. Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: results of the protect study.

Author

Jiménez D, Lobo JL, Monreal M, Moores L, Oribe M, Barrón M, Otero R, Nauffal D, Rabuñal R, Valle R, Navarro C, Rodríguez-Matute C, Alvarez C, Conget F, Uresandi F, Aujesky DA, and Yusen RD

Subjects
Acute Disease, Aged, Aged, 80 and over, Female, Hemodynamics physiology, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Pulmonary Embolism complications, Pulmonary Embolism mortality, Pulmonary Embolism physiopathology, Risk Assessment methods, Spain epidemiology, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right mortality, Multidetector Computed Tomography methods, Pulmonary Embolism diagnostic imaging
Abstract

Background: In patients with acute pulmonary embolism (PE), rapid and accurate risk assessment is paramount in selecting the appropriate treatment strategy. The prognostic value of right ventricular dysfunction (RVD) assessed by multidetector CT (MDCT) in normotensive patients with PE has lacked adequate validation., Methods: The study defined MDCT-assessed RVD as a ratio of the RV to the left ventricle short axis diameter greater than 0.9. Outcomes assessed through 30 days after the diagnosis of PE included all-cause mortality and 'complicated course', which consisted of death from any cause, haemodynamic collapse or recurrent PE., Results: MDCT detected RVD in 533 (63%) of the 848 enrolled patients. Those with RVD on MDCT more frequently had echocardiographic RVD (31%) than those without RVD on MDCT (9.2%) (p<0.001). Patients with RVD on MDCT had significantly higher brain natriuretic peptide (269±447 vs 180±457 pg/ml, p<0.001) and troponin (0.10±0.43 vs 0.03±0.24 ng/ml, p=0.001) levels in comparison with those without RVD on MDCT. During follow-up, death occurred in 25 patients with and in 13 patients without RVD on MDCT (4.7% vs 4.3%; p=0.93). Those with and those without RVD on MDCT had a similar frequency of complicated course (3.9% vs 2.3%; p=0.30)., Conclusions: The PROgnosTic valuE of CT study showed a relationship between RVD assessed by MDCT and other markers of cardiac dysfunction around the time of PE diagnosis, but did not demonstrate an association between MDCT-RVD and prognosis.

Published
2014
Full Text
View/download PDF

41. Clinical outcomes and cost analysis of exacerbations in chronic obstructive pulmonary disease.

Author

Miravitlles M, García-Polo C, Domenech A, Villegas G, Conget F, and de la Roza C

Subjects
Aged, Amoxicillin-Potassium Clavulanate Combination economics, Amoxicillin-Potassium Clavulanate Combination therapeutic use, Aza Compounds economics, Aza Compounds therapeutic use, Cohort Studies, Costs and Cost Analysis, Female, Fluoroquinolones, Follow-Up Studies, Forced Expiratory Volume physiology, Health Care Costs, Hospitalization economics, Humans, Male, Middle Aged, Moxifloxacin, Pulmonary Disease, Chronic Obstructive physiopathology, Quinolines economics, Quinolines therapeutic use, Treatment Failure, Treatment Outcome, Anti-Bacterial Agents economics, Anti-Bacterial Agents therapeutic use, Pulmonary Disease, Chronic Obstructive drug therapy, Pulmonary Disease, Chronic Obstructive economics
Abstract

Background: Exacerbations are a major cause of disability, hospital admissions, and increased healthcare costs in patients with chronic obstructive pulmonary disease (COPD). This study investigated the clinical outcomes of outpatients with moderate to severe exacerbated COPD and their related costs., Methods: An observational study on the outcomes of ambulatory exacerbations of COPD was conducted. The course of the exacerbation was evaluated at a follow-up visit at 4 weeks. A cost analysis that encompassed the use of healthcare resources for treatment of the exacerbation was performed., Results: A total of 260 patients were included, with a mean age of 68.3 years and a mean FEV1 (% predicted) of 58.9 %. Twenty-two percent of patients had significant cardiovascular comorbidity. The most frequently prescribed antibiotics were moxifloxacin in 137 cases and amoxicillin-clavulanate in 50 cases. The rate of failure at 4 weeks was 12.5 %, with no differences between the two most prescribed antibiotics; however, patients treated with moxifloxacin had symptoms for 1.9 fewer days (P = 0.01). The mean cost of the exacerbation was 344.96 (95 % CI: 48.55-641.78), with 9.6 % of the costs for drugs and 72.9 % for hospital care of patients for whom treatment had failed., Conclusions: Antibiotic treatment of our population was in compliance with local guidelines. The rate of failure observed in our study was lower than that reported in previous studies; however, the small percentage of patients that required hospital attention generated almost two-thirds of the total costs of the exacerbations.

Published
2013
Full Text
View/download PDF

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

Author

Bertoletti L, Quenet S, Laporte S, Sahuquillo JC, Conget F, Pedrajas JM, Martin M, Casado I, Riera-Mestre A, and Monreal M

Subjects
Adult, Aged, Aged, 80 and over, Cohort Studies, Comorbidity, Female, Humans, Internationality, Male, Middle Aged, Prevalence, Prognosis, Risk Assessment, Survival Analysis, Survival Rate, Young Adult, Pulmonary Disease, Chronic Obstructive mortality, Pulmonary Embolism mortality, Registries, Venous Thromboembolism mortality
Abstract

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.

Published
2013
Full Text
View/download PDF

43. Echocardiographic assessment of pulmonary arterial pressure in the follow-up of patients with pulmonary embolism.

Author

Otero R, Oribe M, Ballaz A, Jimenez D, Uresandi F, Nauffal D, Conget F, Rodriguez C, Elias T, Jara L, Cayuela A, Blanco I, and Barberá J

Subjects
Aged, Aged, 80 and over, Arteries diagnostic imaging, Chronic Disease, Female, Follow-Up Studies, Hospitalization, Humans, Hypertension, Pulmonary epidemiology, Incidence, Lung blood supply, Male, Middle Aged, Pulmonary Embolism epidemiology, Risk Factors, Spain epidemiology, Ultrasonography, Hypertension, Pulmonary diagnostic imaging, Lung diagnostic imaging, Pulmonary Embolism diagnostic imaging
Abstract

Background: Echocardiography remains a clinically useful screening test for chronic thromboembolic pulmonary hypertension (CTEPH) in patients with a history of pulmonary embolism (PE). To devise an effective screening strategy, the definition of a high-risk group is necessary., Methods: We examined a total of 744 patients with acute symptomatic pulmonary embolism (PE) who were enrolled in a Spanish multicenter study. Patients were monitored every 6months during the first two years, and then once a year thereafter. Transthoracic echocardiography was used to screen patients with a clinical suspicion of CTEPH during follow-up. Pulmonary arterial hypertension was defined as an estimated pulmonary artery systolic pressure (PAP)>50mm Hg. The index thromboembolic episode was considered severe if: (a) the patient was immobilized for medical reasons; or (b) systolic blood pressure was less than 90mm Hg; or (c) troponin T values were above the reference range., Results: The incidence of PAP>50mm Hg at 36months was 8.3% (95% confidence interval=4.6%-14.5%). Statistical analysis showed a highly significant association between a severe index thromboembolic episode and the subsequent detection of PAP>50mm Hg on echocardiography, with high positive likelihood ratio (2.40) and negative predictive value (>0.97)., Conclusions: Patients with a severe index thromboembolic episode would constitute a high-risk group for the development of CTEPH. This group of patients should be subjected to a strict follow-up protocol., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Published
2011
Full Text
View/download PDF

44. Home treatment in pulmonary embolism.

Author

Otero R, Uresandi F, Jiménez D, Cabezudo MA, Oribe M, Nauffal D, Conget F, Rodríguez C, and Cayuela A

Subjects
Aged, Aged, 80 and over, Ambulatory Care, Feasibility Studies, Female, Follow-Up Studies, Hemorrhage complications, Hospitalization, Humans, Interviews as Topic, Male, Middle Aged, Prospective Studies, Pulmonary Embolism etiology, Recurrence, Risk, Thromboembolism complications, Time Factors, Treatment Outcome, Pulmonary Embolism drug therapy, Pulmonary Embolism mortality
Abstract

Background: Limited data exist on the feasibility of providing outpatient care to patients with acute pulmonary embolism (PE)., Methods: We conducted a multicenter randomized clinical trial in acute symptomatic PE to compare the efficacy and safety of early discharge versus standard hospitalization. A clinical prediction rule was used to identify low-risk patients. All patients were followed for three months. The primary outcomes were venous thromboembolic recurrences, major and minor bleeding, and overall mortality., Results: One hundred and thirty two low-risk patients with acute symptomatic PE were randomized to early discharge (n=72) or standard hospitalization (n=60). Overall mortality was 4.2% (95% CI, 0.5-8.9) in the early discharge group and 8.3% (95% CI, 1.1-15) in the standard hospitalization group (Relative Risk (RR) 0.5; 95% confidence interval [CI], 0.12-2.01). Non-fatal recurrences were 2.8% (95% CI, 1.1-6.6) in the early discharge group and 3.3% (95% CI, 1.3-8%) in the standard hospitalization group (RR 0.8; 95% CI, 0.12-5.74). The rates of clinically relevant bleeding were 5.5% in the early discharge group and 5% in the standard hospitalization group (P=0.60). Short-term mortality was 2.8% (95% CI, 0.8-9.6%) in the early discharge group as compared with 0% in the standard hospitalization group. Based on the rate of short-term death in a carefully selected population, the study was suspended., Conclusions: In spite of the number of complications in patients with acute symptomatic PE randomized to standard hospitalization or early discharge did not differ significantly. The rate of short-term mortality was unexpectedly high in a (a priori) low-risk group of patients with acute PE. The accuracy of clinical prediction scores needs to be validated in well designed clinical trials. (ClinicalTrials.gov number, NCT00214929.)., (Copyright (c) 2009 Elsevier Ltd. All rights reserved.)

Published
2010
Full Text
View/download PDF

45. Short-term clinical outcome after acute symptomatic pulmonary embolism.

Author

Conget F, Otero R, Jiménez D, Martí D, Escobar C, Rodríguez C, Uresandi F, Cabezudo MA, Nauffal D, Oribe M, and Yusen R

Subjects
Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Anticoagulants adverse effects, Bed Rest adverse effects, Female, Hemorrhage chemically induced, Hemorrhage mortality, Humans, Hypertension complications, Male, Middle Aged, Missouri, Odds Ratio, Outpatients, Prospective Studies, Pulmonary Embolism etiology, Pulmonary Embolism mortality, Recurrence, Risk Assessment, Risk Factors, Spain, Time Factors, Treatment Outcome, Venous Thromboembolism complications, Venous Thromboembolism mortality, Young Adult, Anticoagulants therapeutic use, Pulmonary Embolism drug therapy, Venous Thromboembolism drug therapy
Abstract

Though studies have identified clinical variables that predict adverse events in patients with acute pulmonary embolism (PE), they have typically not differentiated short-term from long-term predictors. This multicenter prospective cohort study included consecutive outpatients with objectively confirmed symptomatic acute PE. We analyzed the incidence and time course of death, venous thromboembolism (VTE) recurrence, and major bleeding, and we compared event rates during short-term (first week) and long-term (3 months) follow-up after the diagnosis of PE. We also assessed risk factors for short-term mortality. During the first three months after diagnosis of PE, 142 of 1,338 (10.6%) patients died. Thirty-six deaths (2.7%) occurred during the first week after diagnosis of PE, and 61.1% of these were due to PE. Thirty-eight patients (2.8%) had recurrent VTE during the three-month follow-up, though none of the recurrences occurred during the first week after diagnosis of PE. During the three-month follow-up, major bleeding occurred in 48 patients (3.6%). Twenty-one (1.6%) major bleeds occurred during the first week of follow-up, and nine of these were fatal. Short-term mortality was significantly increased in patients who initially presented with systolic arterial hypotension (odds ratio [OR] 3.35; 95% CI, 1.51-5.41) or immobilization due to a medical illness (OR 2.89; 95% confidence interval [CI], 1.31-6.39). In conclusion, during the first week after the diagnosis of PE, death and major bleeding occur more frequently than recurrent VTE. Patients with systolic arterial hypotension and immobilization at the time of PE diagnosis had an increased risk of short-term mortality.

Published
2008

46. [A clinical prediction rule for identifying short-term risk of adverse events in patients with pulmonary thromboembolism].

Author

Uresandi F, Otero R, Cayuela A, Cabezudo MA, Jiménez D, Laserna E, Conget F, Oribe M, and Nauffal D

Subjects
Acute Disease, Female, Humans, Male, Middle Aged, Prevalence, Prospective Studies, Pulmonary Embolism mortality, ROC Curve, Recurrence, Risk Assessment, Risk Factors, Pulmonary Embolism epidemiology
Abstract

Objective: To identify patients with a low short-term risk of complications following acute pulmonary thromboembolism., Patients and Methods: A prospective multicenter study was conducted in 8 Spanish hospitals; 681 consecutive outpatients diagnosed with pulmonary thromboembolism were enrolled. Clinically significant variables were weighted using coefficients derived from a logistic regression model in order to optimize the diagnostic performance of a clinical prediction rule to predict the following complications within 10 days of acute pulmonary thromboembolism: death, recurrent thromboembolism, and major or minor bleeding., Results: Forty-three patients (6.3%) had 51 complications. These included 33 deaths, 12 major bleeding episodes, and 6 minor bleeding episodes. The clinical variables used in the prediction rule were assigned the following scores: recent major bleeding episode and cancer with metastasis, 4 points each; creatinine levels of over 2 mg/dL, 3 points; cancer without metastasis and immobility due to a recent medical condition, 2 points each; and absence of surgery in the past 2 months and an age of over 60 years, 1 point each. A risk score of 2 or less, obtained by 47.8% of patients, indicated a low short-term risk of developing complications following pulmonary thromboembolism. The area under the receiver operating characteristic curve for the prediction rule was 0.75 (95% confidence interval [CI], 0.67-0.83). For this cutoff point, sensitivity was 82.9% (95% CI, 68.7-91.5) and the likelihood ratios for a positive and negative test result were 1.63 (95% CI, 1.39-1.92), and 0.35 (95% CI, 0.18-0.69), respectively., Conclusions: Our clinical prediction rule could be useful for identifying patients with a low risk of complications in the 10 days following acute pulmonary thromboembolism. Those patients would be eligible for consideration for outpatient treatment.

Published
2007
Full Text
View/download PDF

47. Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy.

Author

Jiménez D, Yusen RD, Otero R, Uresandi F, Nauffal D, Laserna E, Conget F, Oribe M, Cabezudo MA, and Díaz G

Subjects
Acute Disease, Anticoagulants adverse effects, Anticoagulants therapeutic use, Cohort Studies, Female, Heparin, Low-Molecular-Weight adverse effects, Heparin, Low-Molecular-Weight therapeutic use, Humans, Male, Predictive Value of Tests, Prognosis, Prospective Studies, Pulmonary Embolism physiopathology, Risk Factors, Treatment Outcome, Ambulatory Care, Decision Support Techniques, Patient Selection, Pulmonary Embolism drug therapy, Pulmonary Embolism mortality, Severity of Illness Index
Abstract

Objective: To assess the performance of two prognostic models in predicting short-term mortality in patients with pulmonary embolism (PE)., Subjects and Methods: We compared the test characteristics of two prognostic models for predicting 30-day outcomes (mortality, thromboembolic recurrences, and major bleeding) in a cohort of 599 patients with objectively confirmed PE. Patients were stratified into the PE severity index (PESI) risk classes I-V and the Geneva low-risk and high-risk strata. We compared the discriminatory power of both prognostic models., Results: The PESI classified fewer patients as low risk (strata I and II) [36%; 216 of 599 patients; 95% confidence interval (CI), 32 to 40%] compared to the Geneva prediction rule (84%; 502 of 599 patients; 95% CI, 81 to 87%) [p < 0.0001]. Using either prediction rule, the low-risk groups showed statistically relevant 30-day mortality difference (PESI, 0.9%; 95% CI, 0.3 to 2.2; vs Geneva, 5.6%; 95% CI, 3.6 to 7.6) [p < 0.0001], although nonfatal recurrent venous thromboembolism or major bleeding rates were statistically similar (PESI, 2.8%; 95% CI, 0.6 to 5.0%; vs Geneva, 4.2%; 95% CI, 2.4 to 5.9%). The area under the receiver operating characteristic curve was higher for the PESI (0.76; 95% CI, 0.69 to 0.83) than for the Geneva score (0.61; 95% CI, 0.51 to 0.71) [p = 0.002]., Conclusions: The PESI quantified the prognosis of patients with PE better than the Geneva score. This study demonstrated that PESI can select patients with very low adverse event rates during the initial days of acute PE therapy and assist in selecting patients for treatment in the outpatient setting.

Published
2007
Full Text
View/download PDF

48. [Early complications in patients with pulmonary embolism].

Author

Nauffal D, Cayuela A, Otero R, Jiménez D, Oribe M, Conget F, Laserna E, Uresandi F, Cabezudo MA, León M, and Doménech R

Subjects
Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Pulmonary Embolism mortality, Pulmonary Embolism complications
Abstract

Background and Objective: Mortality, recurrences and hemorrhages are the most serious early complications of pulmonary embolism (PE). We intended to ascertain the frequency and mechanisms of complications within the first 10 days after PE was diagnosed., Patients and Method: We included patients suspected of suffering PE between December 2003 and August 2004 from 8 hospitals. We performed a multicenter observational prospective study of 8 Spanish hospitals with consecutive outpatients diagnosed with PE. Database of clinical variables: computerized Registry of Patients with Venous Thromboembolism (RIETE). Statistic analysis included chi2 and Student's t test to compare the 2 groups of patients (with and without complications)., Results: Six hundred eighty one patients were included, 336 men and 345 women (mean age 66 and 70, respectively). During the first 10 days, 33 (4.8%) of them died, and 22 (3.2%) had an hemorrhage yet no recurrences appeared. Previous immobilization and the presence of respiratory failure, cancer or renal failure were significantly associated with early complications while previous surgery and thoracic pain were not associated with those., Conclusions: Early complications and some of the associated factors were in agreement with published data. Other situations such as previous surgery or thoracic pain appeared to be protective factors.

Published
2006
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results