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1. Assessment of bleeding events in patients receiving DOACs with or without statins to treat venous thromboembolism: insights from the RIETE registry

Author: Dominique Farge-bancel, R Marqués, M Ortiz, Paolo Prandoni, J Roa, Manuel Monreal, F Couturaud, J Gutierrez, J Pagan, Peter Verhamme, A Aujayeb, Laurent Bertoletti, P Verhamme, M Monreal, S Fonseca, S Pinto, S Soler, A Lorenzo, R Lecumberri, R Otero, P DI MICCO, F Rivera-Cívico, A Molino, P Suchon, C Grange, JA Caprini, J Osorio, Henri Bounameaux, R Valle, F Negro, A Tufano, Remedios Otero, Aitor Ballaz, G Kenet, I Francisco, F Uresandi, G Barillari, Marijan Bosevski, F García-Bragado, E Grau, D Jiménez, A Maestre, A Visonà, J Criado, R Chopard, I Weinberg, M Lumbierres, B Leclercq, H Bounameaux, Farid Rashidi, Abílio Reis, Lucia Mazzolai, P Llamas, MJ Núñez-Fernández, F Dentali, O Espitia, C Siniscalchi, Rosaria Del Giorno, Sanjiv Keller, Carmine Siniscalchi, Luciano Lopez-Jimenez, Ana Cristina Montenegro, Benjamin Brenner, Raquel Barb, Pierpaolo Di Micco, Sebastian Schellong, Inna Tzoran, Radovan Malý, Joseph A. Caprini, Hanh My Bui, MD Adarraga, A Alberich-Conesa, J Aibar, A Alda-Lozano, J Alfonso, C Amado, M Angelina-García, JI Arcelus, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, F Beddar-Chaib, A Blanco-Molina, JC Caballero, J Carrillo-Alonso, G Castellanos, L Chasco, C De Ancos, J Del Toro, P Demelo-Rodríguez, C De Juana-Izquierdo, MC Díaz-Pedroche, JA Díaz-Peromingo, A Dubois-Silva, JC Escribano, C Falgá, AI Farfán-Sedano, C Fernández-Aracil, C Fernández-Capitán, B Fernández-Jiménez, JL Fernández-Reyes, MA Fidalgo, C Gabara, F Galeano-Valle, C García-González, A García-Ortega, O Gavín-Sebastián, MA Gil-De Gómez, A Gil-Díaz, C Gómez-Cuervo, A González-Munera, L Guirado, L Hernández-Blasco, L Jara-Palomares, MJ Jaras, I Jou, MD Joya, JL Lobo, L López-Jiménez, P López-Miguel, H López-Brull, JJ López-Núñez, A López-Ruiz, JB LópezSáez, O Madridano, PJ Marchena, M Marcos, M Martín del Pozo, F Martín-Martos, R Martínez-Prado, JM Maza, E Mena, MI Mercado, J Moisés, MV Morales, MS Navas, JA Nieto, M Olid, L Ordieres-Ortega, S Otálora, N Pacheco-Gómez, AC Palomeque, E Paredes, P Parra-Caballero, P Parra-Rosado, JM Pedrajas, C Pérez-Ductor, M Pérez-Pinar, MA Pérez-Jacoiste, ML Peris, ML Pesce, JA Porras, R Puchades, A Rodríguez-Cobo, M Romero-Brugera, P Ruiz-Artacho, N Ruiz-Giménez, J Ruiz-Ruiz, G Salgueiro, T Sancho, V Sendín, P Sigüenza, A Steinherr, S Suárez-Fernández, R Tirado, A TorrentsVilar, MI Torres, J Trujillo-Santos, JF Varona, A Villalobos, P Villares, C Ay, S Nopp, I Pabinger, C Van Edom, A Verstraete, Yoo HHB, AC Montenegro, SN Morales, J Hirmerova, R Malý, L Bertoletti, A BuraRiviere, J Catella, R Le Mao, I Mahé, F Moustafa, L Plaisance, G Sarlon-Bartoli, E Versini, S Schellong, B Brenner, I Tzoran, P Sadeghipour, F Rashidi, A Abenante, M Basaglia, M Bertoni, F Bilora, B Brandolin, M Ciammaichella, D Colaizzo, E Grandone, E Imbalzano, R Pesavento, A Poz, P Prandoni, B Taflaj, B Zalunardo, A Skride, D Kigitovica, J Meireles, M Bosevski, M Zdraveska, L Mazzolai, and HM Bui
Subjects: Medicine
Abstract: Objective To evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).Design Observational cohort analysis based on a multicentre international registry.Setting Data were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.Participants A total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.Methods Multivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.Results From October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).Conclusions In patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.
Published: 2024
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2. First three months of anticoagulation for venous thromboembolism in non-cancer patients: LMWH VS. VKAs. Findings from the RIETE registry

Author: Manuel J. Núñez Fernández, Cristina Martínez Reglero, José Antonio Nieto Rodríguez, Ana Chouza Piñeiro, Laura Barcia Sixto, Ana Maestre Peiró, Javier Trujillo Santos, Adriana Visonà, José Luis Fernández-Reyes, Manuel Monreal Bosch, M.D. Adarraga, M. Agud, J. Aibar, M.A. Aibar, C. Amado, J.I. Arcelus, C. Baeza, A. Ballaz, R. Barba, C. Barbagelata, M. Barrón, B. Barrón-Andrés, M. Bernal, A. Blanco-Molina, E. Botella, A.M. Camon, I. Cañas, I. Casado, J. Castro, L. Chasco, J. Criado, C. de Ancos, J. de Miguel, J. del Toro, P. Demelo-Rodríguez, J.A. Díaz-Peromingo, M.V. Di Campli, J. Díez-Sierra, I.M. Domínguez, M. Encabo, J.C. Escribano, C. Falgá, A.I. Farfán-Sedano, K. Fernández de Roitegui, C. Fernández-Capitán, J.L. Fernández-Reyes, M.A. Fidalgo, K. Flores, C. Font, L. Font, I. Francisco, I. Furest, C. Gabara, F. Galeano-Valle, M.A. García, F. García-Bragado, M. García de Herreros, R. García-Hernáez, M.M. García-Mullor, A. García-Raso, O. Gavín-Sebastián, A. Gil-Díaz, C. Gómez-Cuervo, J. González-Martínez, E. Grau, M. Giménez-Suau, L. Guirado, J. Gutiérrez, L. Hernández-Blasco, E. Hernando, L. Jara-Palomares, M.J. Jaras, D. Jiménez, M.D. Joya, I. Jou, J. Lima, P. Llamas, J.L. Lobo, L. López-Jiménez, P. López-Miguel, J.J. López-Núñez, R. López-Reyes, J.B. López-Sáez, A. Lorenzo, M. Loring, O. Madridano, A. Maestre, P.J. Marchena, M. Martín del Pozo, F. Martín-Martos, C. Mella, M. Mellado, M.I. Mercado, J. Moisés, M. Monreal, M.V. Morales, A. Muñoz-Blanco, D. Muñoz-Guglielmetti, N. Muñoz-Rivas, M.S. Navas, J.A. Nieto, A. Núñez-Ares, M.J. Núñez-Fernández, B. Obispo, M. Olid, M.C. Olivares, J.L. Orcastegui, M.D. Ortega-Recio, J. Osorio, S. Otalora, R. Otero, P. Parra, V. Parra, J.M. Pedrajas, A. Peinado, G. Pellejero, A. Pérez-Jacoiste, J.A. Porras, J. Portillo, A. Riera-Mestre, A. Rivas, F. Rivera, D.A. Rodríguez-Chiaradía, A. Rodríguez-Cobo, C. Rodríguez-Matute, J. Rogado, R. Rojo, V. Rosa, P. Ruiz-Artacho, N. Ruiz-Giménez, J. Ruiz-Ruiz, P. Ruiz-Sada, J.C. Sahuquillo, G. Salgueiro, A. Sampériz, R. Sánchez-Martínez, J.F. Sánchez-Muñoz-Torrero, T. Sancho, S. Soler, J.M. Suriñach, R. Tirado, M.I. Torres, C. Tolosa, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J.R. Vela, G. Vidal, P. Villares, C. Zamora, P. Gutiérrez, F.J. Vázquez, M. Engelen, T. Vanassche, P. Vehamme, J. Hirmerova, R. Malý, N. Ait Abdallah, L. Bertoletti, A. Bura-Riviere, B. Crichi, P. Debourdeau, O. Espitia, D. Farge-Bancel, H. Helfer, I. Mahé, F. Moustafa, G. Poenou, S. Schellong, A. Braester, B. Brenner, I. Tzoran, F. Bilora, B. Brandolin, E. Bucherini, M. Ciammaichella, D. Colaizzo, P. Di Micco, E. Grandone, E. Imbalzano, R. Maida, D. Mastroiacovo, F. Pace, R. Pesavento, P. Prandoni, R. Quintavalla, A. Rocci, C. Siniscalchi, A. Tufano, A. Visonà, B. Zalunardo, A. Skride, S. Strautmane, A. Zaicenko, M. Ferreira, S. Fonseca, F. Martins, J. Meireles, M. Bosevski, H. Bounameaux, L. Mazzolai, J.A. Caprini, A.J. Tafur, I. Weinberg, H. Wilkins, and H.M. Bui
Subjects: Long-term treatment. low molecular weight heparin. vitamin k-antagonist. venous thrombosis. pulmonary embolism. deep vein thrombosis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background: The use of low-molecular-weight heparin (LMWH) for long-term therapy of venous thromboembolism (VTE) in patients without cancer has not been consistently evaluated. Methods: We used the data in the RIETE registry to compare the 3-month outcomes (VTE recurrences, major bleeding or death) in non-cancer patients with VTE, according to long-term therapy with LMWH or vitamin K antagonists (VKAs). Results: As of March 2018, 14,582 non-cancer patients with VTE had received initial therapy with LMWH and then switched to VKAs, while 9151 were prescribed LMWH for initial and long-term therapy. Overall, 11,494 had initially presented with pulmonary embolism (PE) and 12,239 with isolated deep vein thrombosis (DVT). Among 11,494 patients initially presenting with PE, 84 had VTE recurrences, 204 major bleeding and 406 died. Among 12,239 patients with isolated DVT, 133 developed VTE recurrences, 137 bled and 289 died. On propensity score analysis, PE patients on long-term LMWH therapy were at increased risk for PE recurrences (OR: 3.30; 95%CI: 1.67–6.48), major bleeding (OR: 1.68; 95%CI: 1.21–2.32) or death (OR: 3.16; 95%CI: 2.43–4.09) compared with those receiving VKAs. In patients with DVT, those on long-term LMWH also were at increased risk for PE recurrences (OR: 2.31; 95%CI: 1.13–4.73), major bleeding (OR 2.28; 95%CI: 1.51–3.44) or death (OR: 2.32; 95%CI: 1.54–3.51). Conclusions: In the RIETE non-cancer patients with VTE, long-term therapy with VKAs was associated with a lower risk for recurrences, major bleeding or death.
Published: 2020
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3. Heart Rate and Mortality in Patients With Acute Symptomatic Pulmonary Embolism

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

4. Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study

Author: Trujillo-Santos J, Farge-Bancel D, Pedrajas JM, Gómez-Cuervo C, Ballaz A, Braester A, Mahé I, Villalobos A, Porras JA, Monreal M, RIETE Investigators, M D Adarraga, J Aibar, M A Aibar, C Amado, J I Arcelus, A Asuero, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, A Blanco-Molina, E Botella, A M Camon, I Casado, J Castro, M Castro, L Chasco, J Criado, C de Ancos, J Del Toro, P Demelo-Rodríguez, A M Díaz-Brasero, J A Díaz-Peromingo, M V Di Campli, A Dubois-Silva, J C Escribano, F Espósito, C Falgá, A I Farfán-Sedano, C Fernández-Capitán, J L Fernández-Reyes, M A Fidalgo, K Flores, C Font, L Font, I Francisco, C Gabara, F Galeano-Valle, M A García, F García-Bragado, M García de Herreros, R García de la Garza, C García-Díaz, R García-Hernáez, A García-Raso, A Gil-Díaz, M Giménez-Suau, E Grau, L Guirado, J Gutiérrez, L Hernández-Blasco, E Hernando, L Jara-Palomares, M J Jaras, D Jiménez, R Jiménez, C Jiménez-Alfaro, M D Joya, S Lainez-Justo, A Latorre, J Lima, P Llamas, J L Lobo, L López-Jiménez, P López-Miguel, J J López-Núñez, R López-Reyes, J B López-Sáez, A Lorenzo, O Madridano, A Maestre, P J Marchena, F Martín-Martos, D Martínez-Urbistondo, C Mella, M I Mercado, J Moisés, M V Morales, A Muñoz-Blanco, N Muñoz-Rivas, M S Navas, J A Nieto, E Nofuentes-Pérez, M J Núñez-Fernández, B Obispo, M Olid, M C Olivares, J L Orcastegui, J Osorio, S Otalora, R Otero, D Paredes, P Parra, G Pellejero, J Portillo, F Rivera-Civico, D A Rodríguez-Chiaradía, C Rodríguez-Matute, J Rogado, V Rosa, P Ruiz-Artacho, N Ruiz-Giménez, J Ruiz-Ruiz, P Ruiz-Sada, G Salgueiro, R Sánchez-Martínez, J F Sánchez-Muñoz-Torrero, T Sancho, S Soler, B Suárez-Rodríguez, J M Suriñach, R Tirado, M I Torres, C Tolosa, F Uresandi, B Valero, R Valle, J F Varona, G Vidal, P Villares, C Zamora, M Engelen, T Vanassche, P Verhamme, J Hirmerova, R Malý, N Ait Abdallah, L Bertoletti, A Bura-Riviere, J Catella, F Couturaud, B Crichi, P Debourdeau, O Espitia, N Falvo, H Helfer, K Lacut, R Le Mao, F Moustafa, G Poenou, I Quere, S Schellong, B Brenner, I Tzoran, R Nikandish, F Bilora, B Brandolin, M Ciammaichella, P Di Micco, E Imbalzano, R Maida, F Pace, R Pesavento, P Prandoni, R Quintavalla, A Rocci, C Siniscalchi, A Tufano, A Visonà, B Zalunardo, J Birzulis, A Skride, A Zaicenko, S Fonseca, F Martins, J Meireles, M Bosevski, H Bounameaux, L Mazzolai, C I Ochoa-Chaar, I Weinberg, H M Bui, J, Trujillo-Santo, D, Farge-Bancel, Jm, Pedraja, C, Gómez-Cuervo, A, Ballaz, A, Braester, I, Mahé, A, Villalobo, Ja, Porra, M, Monreal, Investigators, Riete, D Adarraga, M, Aibar, J, A Aibar, M, Amado, C, I Arcelus, J, Asuero, A, Barba, R, Barbagelata, C, Barrón, M, Barrón-Andrés, B, Blanco-Molina, A, Botella, E, M Camon, A, Casado, I, Castro, J, Castro, M, Chasco, L, Criado, J, de Ancos, C, Del Toro, J, Demelo-Rodríguez, P, M Díaz-Brasero, A, A Díaz-Peromingo, J, V Di Campli, M, Dubois-Silva, A, C Escribano, J, Espósito, F, Falgá, C, I Farfán-Sedano, A, Fernández-Capitán, C, L Fernández-Reyes, J, A Fidalgo, M, Flores, K, Font, C, Font, L, Francisco, I, Gabara, C, Galeano-Valle, F, A García, M, García-Bragado, F, García de Herreros, M, García de la Garza, R, García-Díaz, C, García-Hernáez, R, García-Raso, A, Gil-Díaz, A, Giménez-Suau, M, Grau, E, Guirado, L, Gutiérrez, J, Hernández-Blasco, L, Hernando, E, Jara-Palomares, L, J Jaras, M, Jiménez, D, Jiménez, R, Jiménez-Alfaro, C, D Joya, M, Lainez-Justo, S, Latorre, A, Lima, J, Llamas, P, L Lobo, J, López-Jiménez, L, López-Miguel, P, J López-Núñez, J, López-Reyes, R, B López-Sáez, J, Lorenzo, A, Madridano, O, Maestre, A, J Marchena, P, Martín-Martos, F, Martínez-Urbistondo, D, Mella, C, I Mercado, M, Moisés, J, V Morales, M, Muñoz-Blanco, A, Muñoz-Rivas, N, S Navas, M, A Nieto, J, Nofuentes-Pérez, E, J Núñez-Fernández, M, Obispo, B, Olid, M, C Olivares, M, L Orcastegui, J, Osorio, J, Otalora, S, Otero, R, Paredes, D, Parra, P, Pellejero, G, Portillo, J, Rivera-Civico, F, A Rodríguez-Chiaradía, D, Rodríguez-Matute, C, Rogado, J, Rosa, V, Ruiz-Artacho, P, Ruiz-Giménez, N, Ruiz-Ruiz, J, Ruiz-Sada, P, Salgueiro, G, Sánchez-Martínez, R, F Sánchez-Muñoz-Torrero, J, Sancho, T, Soler, S, Suárez-Rodríguez, B, M Suriñach, J, Tirado, R, I Torres, M, Tolosa, C, Uresandi, F, Valero, B, Valle, R, F Varona, J, Vidal, G, Villares, P, Zamora, C, Engelen, M, Vanassche, T, Verhamme, P, Hirmerova, J, Malý, R, Ait Abdallah, N, Bertoletti, L, Bura-Riviere, A, Catella, J, Couturaud, F, Crichi, B, Debourdeau, P, Espitia, O, Falvo, N, Helfer, H, Lacut, K, Le Mao, R, Moustafa, F, Poenou, G, Quere, I, Schellong, S, Brenner, B, Tzoran, I, Nikandish, R, Bilora, F, Brandolin, B, Ciammaichella, M, Di Micco, P, Imbalzano, E, Maida, R, Pace, F, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tufano, A, Visonà, A, Zalunardo, B, Birzulis, J, Skride, A, Zaicenko, A, Fonseca, S, Martins, F, Meireles, J, Bosevski, M, Bounameaux, H, Mazzolai, L, I Ochoa-Chaar, C, Weinberg, I, and M Bui, H
Subjects: dalteparin, recurrences, tinzaparin, venous thromboembolism, cancer, enoxaparin, Hematology, cohort, LMWH
Abstract: Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a leading cause of morbidity and death. The objective of the RIETECAT study was to compare the long-term effectiveness and safety of enoxaparin versus dalteparin or tinzaparin for the secondary prevention of VTE in adults with active cancer. We used the data from the multicenter, multinational RIETE registry to compare the rates of VTE recurrences, major bleeding, or death over 6 months in patients with active cancer and acute VTE using full doses of enoxaparin versus dalteparin or tinzaparin, and a multivariable Cox proportional hazard model was used to analyze the primary end point. From January 2009 to June 2018, 4451 patients with active cancer received full doses of the study drugs: enoxaparin, 3526 patients; and dalteparin or tinzaparin, 925 (754 + 171) patients. There was limited difference in VTE recurrences (2.0% vs 2.5%) and mortality rate (19% vs 17%) between the enoxaparin and dalteparin or tinzaparin subgroups. However, there was a slight numerical increase in major bleeding (3.1% vs 1.9%). Propensity score matching confirmed that there were no differences in the risk for VTE recurrences (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.48-1.38), major bleeding (aHR, 1.40; 95% CI, 0.80-2.46), or death (aHR, 1.07; 95% CI, 0.88-1.30) between subgroups. In RIETECAT, in patients with cancer and VTE receiving full-dose enoxaparin or dalteparin or tinzaparin, no statistically significant differences were observed regarding effectiveness and safety outcomes over a 6-month period.
Published: 2022

5. Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation

Author: Carmen Fernández‐Capitán, Ana Rodriguez Cobo, David Jiménez, Olga Madridano, Maurizio Ciammaichella, Esther Usandizaga, Remedios Otero, Pierpaolo Di Micco, Farès Moustafa, Manuel Monreal, M.D. Adarraga, M.A. Aibar, M. Alfonsa, J.I. Arcelus, P. Azcarate‐Agüero, A. Ballaz, P. Baños, R. Barba, M. Barrón, B. Barrón‐Andrés, J. Bascuñana, A. Blanco‐Molina, A.M. Camón, L. Chasco, A.J. Cruz, R. del Pozo, J. de Miguel, J. del Toro, M.C. Díaz‐Pedroche, J.A. Díaz‐Peromingo, J.C. Escribano, C. Falgá, C. Fernández‐Aracil, M.A. Fidalgo, C. Font, L. Font, M.A. García, F. García‐Bragado, M. García‐Morillo, A. García‐Raso, A.I. García‐Sánchez, O. Gavín, I. Gaya, C. Gómez, V. Gómez, J. González, E. Grau, R. Guijarro, J. Gutiérrez, G. Hernández‐Comes, L. Hernández‐Blasco, E. Hernando, L. Jara‐Palomares, M.J. Jaras, D. Jiménez, M.D. Joya, J. Lima, P. Llamas, J.L. Lobo, R. López‐Reyes, J.B. López‐Sáez, M.A. Lorente, A. Lorenzo, M. Lumbierres, A. Maestre, P.J. Marchena, F. Martín‐Martos, M. Martín‐Romero, M.V. Morales, J.A. Nieto, S. Nieto, A. Núñez, M.J. Núñez, M. Odriozola, M.C. Olivares, S. Otalora, J.M. Pedrajas, G. Pellejero, C. Pérez‐Ductor, M.L. Peris, I. Pons, J.A. Porras, L. Ramírez, O. Reig, A. Riera‐Mestre, D. Riesco, A. Rivas, M.A. Rodríguez‐Dávila, V. Rosa, P. Ruiz‐Artacho, J.C. Sahuquillo, M.C. Sala‐Sainz, A. Sampériz, R. Sánchez‐Martínez, S. Soler, B. Sopeña, J.M. Suriñach, C. Tolosa, M.I. Torres, J. Troya, J. Trujillo‐Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, L. Vela, G. Vidal, A. Villalobos, T. Vanassche, C. Vandenbriele, P. Verhamme, H.H.B. Yoo, P. Wells, J. Hirmerova, R. Malý, E. Salgado, L. Bertoletti, A. Bura‐Riviere, N. Falvo, D. Farge‐Bancel, A. Hij, I. Mahé, I. Quere, A. Braester, B. Brenner, M. Ellis, I. Tzoran, G. Antonucci, G. Barillari, F. Bilora, C. Bortoluzzi, E. Bucherini, A. Camerota, C. Cattabiani, F. Dentali, R. Duce, M. Giorgi‐Pierfranceschi, E. Grandone, E. Imbalzano, G. Lessiani, R. Maida, D. Mastroiacovo, F. Pace, R. Pesavento, M. Pesavento, R. Poggio, P. Prandoni, R. Quintavalla, A. Rocci, C. Siniscalchi, E. Tiraferri, D. Tonello, A. Visonà, B. Zalunardo, V. Gibietis, A. Skride, B. Vitola, A. Alatri, H. Bounameaux, L. Calanca, and L. Mazzolai
Subjects: Subsegmental, medicine.medical_specialty, anticoagulant, deep vein thrombosis, outcomes, pulmonary embolism, subsegmental, medicine.drug_class, Deep vein, Outcomes, Deep vein thrombosis, Internal medicine, medicine, First episode, lcsh:RC633-647.5, business.industry, Pulmonary embolism, Hazard ratio, Anticoagulant, Anticoagulants, lcsh:Diseases of the blood and blood-forming organs, Hematology, Heparin, Original Articles ‐ Thrombosis, medicine.disease, Thrombosis, Confidence interval, medicine.anatomical_structure, Cardiology, Original Article, business, medicine.drug
Abstract: The RIETE Investigators., [Background] The optimal therapy of patients with acute subsegmental pulmonary embolism (PE) is controversial., [Methods] We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic PE recurrences during anticoagulation in patients with subsegmental, segmental, or more central PEs. [Results] Among 15 963 patients with a first episode of symptomatic PE, 834 (5.2%) had subsegmental PE, 3797 (24%) segmental, and 11 332 (71%) more central PE. Most patients in all subgroups received initial therapy with low‐molecular‐weight heparin, and then most switched to vitamin K antagonists. Median duration of therapy was 179, 185, and 204 days, respectively. During anticoagulation, 183 patients developed PE recurrences, 131 developed deep vein thrombosis (DVT), 543 bled, and 1718 died (fatal PE, 135). The rate of PE recurrences was twofold higher in patients with subsegmental PE than in those with segmental (hazard ratio [HR], 2.13; 95% confidence interval [CI], 1.16‐3.85) or more central PE (HR, 1.89; 95% CI, 1.12‐3.13). On multivariable analysis, patients with subsegmental PE had a higher risk for PE recurrences than those with central PE (adjusted HR, 1.75; 95% CI, 1.02‐3.03). After stratifying patients with subsegmental PE according to ultrasound imaging in the lower limbs, the rate of PE recurrences was similar in patients with DVT, in patients without DVT, and in those with no ultrasound imaging. [Conclusions] Our study reveals that the risk for PE recurrences in patients with segmental PE is not lower than in those with more central PE, thus suggesting that the risk of PE recurrences is not influenced by the anatomic location of PE.
Published: 2021

6. Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study

Author: Marc Blondon, David Jimenez, Helia Robert‐Ebadi, Jorge Del Toro, Luciano Lopez‐Jimenez, Conxita Falga, Andris Skride, Llorenç Font, Fernando Javier Vazquez, Henri Bounameaux, Manuel Monreal, Paolo Prandoni, Benjamin Brenner, Dominique Farge‐Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Radovan Malý, Peter Verhamme, Joseph A Caprini, Hanh My Bui, MD Adarraga, M Agud, J Aibar, MA Aibar, J Alfonso, C Amado, JI Arcelus, C Baeza, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón‐Andrés, A Blanco‐Molina, E Botella, AM Camon, J Castro, MA Caudevilla, P Cerdà, L Chasco, J Criado, C de Ancos, J de Miguel, P Demelo‐Rodríguez, JA Díaz‐Peromingo, J Díez‐Sierra, R Díaz‐Simón, IM Domínguez, M Encabo, JC Escribano, C Falgá, AI Farfán, C Fernández‐Capitán, JL Fernández‐Reyes, MA Fidalgo, K Flores, C Font, I Francisco, C Gabara, F Galeano‐Valle, MA García, F García‐Bragado, MM García‐Mullor, O Gavín‐Blanco, O Gavín‐Sebastián, A Gil‐Díaz, C Gómez‐Cuervo, J González‐Martínez, E Grau, L Guirado, J Gutiérrez, L Hernández‐Blasco, L Jara‐Palomares, MJ Jaras, D Jiménez, MD Joya, I Jou, B Lacruz, R Lecumberri, J Lima, JL Lobo, H López‐Brull, L López‐Jiménez, P López‐Miguel, JJ López‐Núñez, R López‐Reyes, JB López‐Sáez, MA Lorente, A Lorenzo, M Loring, O Madridano, A Maestre, PJ Marchena, M Martín del Pozo, F Martín‐Martos, C Martínez‐Baquerizo, C Mella, M Mellado, MI Mercado, J Moisés, MV Morales, A Muñoz‐Blanco, D Muñoz‐Guglielmetti, N Muñoz‐Rivas, E Nart, JA Nieto, MJ Núñez, MC Olivares, C Ortega‐Michel, MD Ortega‐Recio, J Osorio, S Otalora, R Otero, P Parra, V Parra, JM Pedrajas, G Pellejero, A Pérez‐Jacoiste, ML Peris, D Pesántez, JA Porras, J Portillo, L Reig, A Riera‐Mestre, A Rivas, A Rodríguez‐Cobo, C Rodríguez‐Matute, J Rogado, V Rosa, CM Rubio, P Ruiz‐Artacho, N Ruiz‐Giménez, J Ruiz‐Ruiz, P Ruiz‐Sada, JC Sahuquillo, G Salgueiro, A Sampériz, JF Sánchez‐Muñoz‐Torrero, T Sancho, P Sigüenza, M Sirisi, S Soler, S Suárez, JM Suriñach, G Tiberio, MI Torres, C Tolosa, J Trujillo‐Santos, F Uresandi, E Usandizaga, R Valle, JR Vela, G Vidal, C Vilar, P Villares, C Zamora, P Gutiérrez, FJ Vázquez, T Vanassche, C Vandenbriele, P Verhamme, J Hirmerova, R Malý, E Salgado, I Benzidia, L Bertoletti, A Bura‐Riviere, B Crichi, P Debourdeau, O Espitia, D Farge‐Bancel, H Helfer, I Mahé, F Moustafa, G Poenou, S Schellong, A Braester, B Brenner, I Tzoran, M Amitrano, F Bilora, C Bortoluzzi, B Brandolin, M Ciammaichella, D Colaizzo, F Dentali, P Di Micco, E Giammarino, E Grandone, S Mangiacapra, D Mastroiacovo, R Maida, N Mumoli, F Pace, R Pesavento, F Pomero, P Prandoni, R Quintavalla, A Rocci, C Siniscalchi, A Tufano, A Visonà, N Vo Hong, B Zalunardo, RV Kalejs, K Maķe, M Ferreira, S Fonseca, F Martins, J Meireles, M Bosevski, M Zdraveska, L Mazzolai, JA Caprini, AJ Tafur, I Weinberg, H Wilkins, HM Bui, Blondon, M., Jimenez, D., Robert-Ebadi, H., Del Toro, J., Lopez-Jimenez, L., Falga, C., Skride, A., Font, L., Vazquez, F. J., Bounameaux, H., Monreal, M., Prandoni, P., Brenner, B., Farge-Bancel, D., Barba, R., Di Micco, P., Bertoletti, L., Schellong, S., Tzoran, I., Reis, A., Bosevski, M., Maly, R., Verhamme, P., Caprini, J. A., My Bui, H., Adarraga, M. D., Agud, M., Aibar, J., Aibar, M. A., Alfonso, J., Amado, C., Arcelus, J. I., Baeza, C., Ballaz, A., Barbagelata, C., Barron, M., Barron-Andres, B., Blanco-Molina, A., Botella, E., Camon, A. M., Castro, J., Caudevilla, M. A., Cerda, P., Chasco, L., Criado, J., de Ancos, C., de Miguel, J., Demelo-Rodriguez, P., Diaz-Peromingo, J. A., Diez-Sierra, J., Diaz-Simon, R., Dominguez, I. M., Encabo, M., Escribano, J. C., Farfan, A. I., Fernandez-Capitan, C., Fernandez-Reyes, J. L., Fidalgo, M. A., Flores, K., Font, C., Francisco, I., Gabara, C., Galeano-Valle, F., Garcia, M. A., Garcia-Bragado, F., Garcia-Mullor, M. M., Gavin-Blanco, O., Gavin-Sebastian, O., Gil-Diaz, A., Gomez-Cuervo, C., Gonzalez-Martinez, J., Grau, E., Guirado, L., Gutierrez, J., Hernandez-Blasco, L., Jara-Palomares, L., Jaras, M. J., Joya, M. D., Jou, I., Lacruz, B., Lecumberri, R., Lima, J., Lobo, J. L., Lopez-Brull, H., Lopez-Miguel, P., Lopez-Nunez, J. J., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Lorenzo, A., Loring, M., Madridano, O., Maestre, A., Marchena, P. J., Martin del Pozo, M., Martin-Martos, F., Martinez-Baquerizo, C., Mella, C., Mellado, M., Mercado, M. I., Moises, J., Morales, M. V., Munoz-Blanco, A., Munoz-Guglielmetti, D., Munoz-Rivas, N., Nart, E., Nieto, J. A., Nunez, M. J., Olivares, M. C., Ortega-Michel, C., Ortega-Recio, M. D., Osorio, J., Otalora, S., Otero, R., Parra, P., Parra, V., Pedrajas, J. M., Pellejero, G., Perez-Jacoiste, A., Peris, M. L., Pesantez, D., Porras, J. A., Portillo, J., Reig, L., Riera-Mestre, A., Rivas, A., Rodriguez-Cobo, A., Rodriguez-Matute, C., Rogado, J., Rosa, V., Rubio, C. M., Ruiz-Artacho, P., Ruiz-Gimenez, N., Ruiz-Ruiz, J., Ruiz-Sada, P., Sahuquillo, J. C., Salgueiro, G., Samperiz, A., Sanchez-Munoz-Torrero, J. F., Sancho, T., Siguenza, P., Sirisi, M., Soler, S., Suarez, S., Surinach, J. M., Tiberio, G., Torres, M. I., Tolosa, C., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J. R., Vidal, G., Vilar, C., Villares, P., Zamora, C., Gutierrez, P., Vanassche, T., Vandenbriele, C., Hirmerova, J., Salgado, E., Benzidia, I., Bura-Riviere, A., Crichi, B., Debourdeau, P., Espitia, O., Helfer, H., Mahe, I., Moustafa, F., Poenou, G., Braester, A., Amitrano, M., Bilora, F., Bortoluzzi, C., Brandolin, B., Ciammaichella, M., Colaizzo, D., Dentali, F., Giammarino, E., Grandone, E., Mangiacapra, S., Mastroiacovo, D., Maida, R., Mumoli, N., Pace, F., Pesavento, R., Pomero, F., Quintavalla, R., Rocci, A., Siniscalchi, C., Tufano, A., Visona, A., Vo Hong, N., Zalunardo, B., Kalejs, R. V., Maie, K., Ferreira, M., Fonseca, S., Martins, F., Meireles, J., Zdraveska, M., Mazzolai, L., Tafur, A. J., Weinberg, I., Wilkins, H., and Bui, H. M.
Subjects: Registrie, medicine.medical_specialty, pulmonary embolism, Prognosi, Hemodynamics, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, Clinical prognosis, 0302 clinical medicine, Recurrence, Internal medicine, Case fatality rate, medicine, Humans, hemorrhage, mortality, prognosis, thrombolytic therapy, Registries, cardiovascular diseases, business.industry, Anticoagulant, Anticoagulants, Hematology, Venous Thromboembolism, Prognosis, medicine.disease, Confidence interval, Pulmonary embolism, Discontinuation, Cohort Studie, business, Venous thromboembolism, Cohort study, Human
Abstract: Aims Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. Methods and results We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (
Published: 2021

7. Timing and characteristics of venous thromboembolism after noncancer surgery

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

8. The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site

Author: Alicia Lorenzo, E. Tiraferri, J.M. Martín-Antorán, I. Mahé, Bernardo Sopeña, Luciano López-Jiménez, Carmen Fernández-Capitán, M.L. Peris, M.A. Rodríguez-Dávila, Carme Font, Luca Calanca, Lidia Luciana Rota, A. Merah, C. Font, Lucia Mazzolai, J.M. Suriñach, M.A. Aibar, J. Vela, Daniela Mastroiacovo, Juan I. Arcelus, I. Casado, Elvira Grandone, Inna Tzoran, Laurent Bertoletti, Maria Luisa Peris, J.A. Nieto, C. Pérez, Adriana Visonà, L. Guirado, J. González, L. Bertoletti, G. Candeloro, J. Villalta, A. Riera, Ángeles Blanco-Molina, J. del Toro, J.L. Ribeiro, A. Belovs, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, Javier Trujillo-Santos, Vladimir Rosa, S. Otalora, G. Pérez, Fernando Uresandi, L. Ramírez, V. Gómez, Jean Chidiac, G. Tiberio, David Jiménez, Radovan Malý, T. Tomko, Aitor Ballaz, J. Hirmerova, Pablo Javier Marchena, C. Tolosa, Jose Gutierrez, Peter Verhamme, A. Grimón, M. Monreal, N. Ruiz-Giménez, E. Grau, G. Hernández, I. Suarez, M.V. Morales, Andris Skride, Raquel López-Reyes, Ángel Sampériz, Giovanni Barillari, Cristina Perez Ductor, R. Valle, M.S. Sousa, J.A. Porras, D. Farge-Bancel, Conxita Falga, P. García-Brotons, P. Malfante, Madalena Moreira, F. Martín-Martos, P. Gallego, O. Sanz, Santiago Nieto, B. Pagán, Hervé Decousus, O. Reig, L. Font, Corrado Lodigiani, F. García-Bragado, Maurizio Ciammaichella, A. Alatri, Isabelle Mahé, M. Pinelli, Philip S. Wells, Remedios Otero, Henri Bounameaux, José María Pedrajas, V. Isern, Manolis Papadakis, Pedro Ruiz-Artacho, B. Barrón-Andrés, F. Pace, E. Salgado, Beatriz Lacruz, Raquel Barba, A. Apollonio, J.B. López-Sáez, J. Bascuñana, M.A. Lorente, M.J. Núñez, Antonella Tufano, E. Grandone, A. Braester, Dolores Nauffal, Agustina Rivas, Barry M. Brenner, Silvia Soler, Paolo Prandoni, P. Di Micco, S. Nieto, J.C. Serrano, Abílio Reis, T. Bueso, Paola Ferrazzi, Luis Jara-Palomares, C. Ruiz-Martínez, Gianfranco Lessiani, José Luis Lobo, M. Zdraveska, Marijan Bosevski, C. Sala, J. de Miguel, L. Hernández-Blasco, A. Hij, Ramón Lecumberri, A. Culla, Olga Madridano, J.A. Díaz-Peromingo, M. Barrón, and J. Trujillo-Santos
Subjects: Male, Oncology, medicine.medical_specialty, Lung Neoplasms, Colorectal cancer, medicine.drug_class, Breast Neoplasms, Hemorrhage, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Recurrence, Prostate, Neoplasms, Internal medicine, medicine, Humans, Registries, Lung cancer, Aged, business.industry, Anticoagulant, Anticoagulants, Prostatic Neoplasms, Cancer, Venous Thromboembolism, General Medicine, Middle Aged, medicine.disease, Primary tumor, Confidence interval, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Disease Progression, Female, Colorectal Neoplasms, business
Abstract: Background We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). Conclusions Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.
Published: 2017

9. Gender differences in patients with venous thromboembolism and five common sites of cancer

Author: Joan Carles Sahuquillo, Jorge Del Toro, Javier Trujillo-Santos, Giovanni Barillari, F. Martín-Martos, Manuel Monreal, Alessandra Bura-Rivière, Silvia Soler, Isabelle Mahé, and Alicia Lorenzo
Subjects: Male, medicine.medical_specialty, Colorectal cancer, Hemorrhage, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Recurrence, Internal medicine, Neoplasms, medicine, Humans, In patient, 030212 general & internal medicine, Lung cancer, Aged, Aged, 80 and over, Lung, business.industry, Cancer, Anticoagulants, Hematology, Heparin, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Treatment Outcome, Relative risk, Female, business, Venous thromboembolism, medicine.drug
Abstract: Background The outcome of cancer patients with venous thromboembolism (VTE) may differ according to gender. Methods We used the RIETE database to compare the rate of VTE recurrences, major bleeding and mortality in patients with lung, colorectal, pancreatic, hematologic or gastric cancer during the course of anticoagulation, according to gender. Results As of January 2016, 11,055 patients with active cancer were enrolled: 1,727 had lung cancer, 1,592 colorectal, 840 hematologic, 517 pancreatic and 459 had gastric cancer. Compared with men (N = 3,130), women (N = 2,005) were more likely to have colorectal, pancreatic or hematologic cancer, and less likely to have lung cancer. Most patients (91%) were initially treated with low-molecular-weight heparin (LMWH), but women received higher daily doses per body weight. Then, 66% kept receiving LMWH for long-term therapy. During the course of anticoagulation, 302 patients developed recurrent VTE, 220 bled and 1,749 died. Compared with men, women had a similar rate of VTE recurrences or major bleeding, and a lower mortality (risk ratio [RR]: 0.90; 95% CI: 0.82–0.99). When separately comparing outcomes according to cancer site, women with lung cancer had a lower mortality (RR: 0.79; 95% CI: 0.70–0.92), those with colorectal cancer had a higher mortality (RR: 1.25; 95% CI: 1.02–1.54) and those with gastric cancer had a higher rate of VTE recurrences than men (RR: 2.47; 95% CI: 1.04–5.89). Conclusions VTE women with lung, colorectal, pancreatic, haematological or gastric cancer experienced a similar outcome during the course of anticoagulant therapy than men with similar cancers.
Published: 2017

10. Clinical outcomes during anticoagulant therapy in fragile patients with venous thromboembolism

Author: Farès Moustafa, Matteo Giorgi Pierfranceschi, Pierpaolo Di Micco, Eugenio Bucherini, Alicia Lorenzo, Aurora Villalobos, José A. Nieto, Beatriz Valero, Ángel L. Sampériz, Manuel Monreal, Hervé Decousus, Paolo Prandoni, Benjamin Brenner, Raquel Barba, Laurent Bertoletti, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Philip Wells, Manolis Papadakis, MD Adarraga, P Agudo, MA Aibar, M Alfonso, JI Arcelus, A Ballaz, R Barba, M Barrón, B Barrón‐Andrés, J Bascuñana, A Blanco‐Molina, I Cañas, I Casado, N Chic, R del Pozo, J del Toro, MC Díaz‐Pedroche, JA Díaz‐Peromingo, C Falgá, C Fernández‐Aracil, C Fernández‐Capitán, MA Fidalgo, C Font, L Font, P Gallego, MA García, F García‐Bragado, O Gavín, C Gómez, V Gómez, J González, E Grau, A Grimón, R Guijarro, L Guirado, J Gutiérrez, G Hernández‐Comes, L Hernández‐Blasco, L Jara‐Palomares, MJ Jaras, D Jiménez, J Jiménez, MD Joya, P Llamas, JL Lobo, P López, L López‐Jiménez, R López‐Reyes, JB López‐Sáez, MA Lorente, M Lumbierres, JM Luque, PJ Marchena, F Martín‐Martos, M Mellado, S Nieto, A Núñez, MJ Núñez, S Otalora, R Otero, JM Pedrajas, G Pérez, C Pérez‐Ductor, ML Peris, I Pons, JA Porras, O Reig, A Riera‐Mestre, D Riesco, A Rivas, M Rodríguez, MA Rodríguez‐Dávila, V Rosa, E Rosillo‐Hernández, P Ruiz‐Artacho, N Ruiz‐Giménez, JC Sahuquillo, MC Sala‐Sainz, R Sánchez‐Martínez, O Sanz, S Soler, B Sopeña, JM Suriñach, C Tolosa, MI Torres, J Troya, J Trujillo‐Santos, F Uresandi, E Usandizaga, R Valle, J Vela, L Vela, MP Vicente, B Xifre, T Vanassche, P Verhamme, HHB Yoo, P Wells, J Hirmerova, R Malý, P Dulíček, E Salgado, L Bertoletti, A Bura‐Riviere, D Farge‐Bancel, A Hij, I Mahé, A Merah, A Braester, B Brenner, I Tzoran, G Antonucci, G Barillari, F Bilora, C Bortoluzzi, B Brandolin, C Cattabiani, M Ciammaichella, N Dell'Elce, F Dentali, R Duce, E Grandone, E Imbalzano, G Lessiani, R Maida, D Mastroiacovo, F Pace, R Parisi, M Pellegrinet, R Pesavento, M Pinelli, R Poggio, P Prandoni, R Quintavalla, A Rocci, E Tiraferri, D Tonello, A Tufano, A Visonà, V Gibietis, A Skride, B Vitola, M Bosevski, M Zdraveska, H Bounameaux, L Mazzolai, RIETE Investigators, Decousus, H., Prandoni, P., Brenner, B., Barba, R., Bertoletti, L., Tzoran, I., Reis, A., Bosevski, M., Bounameaux, H., Malý, R., Wells, P., Papadakis, M., Adarraga, M.D., Agudo, P., Aibar, M.A., Alfonso, M., Arcelus, J.I., Ballaz, A., Barrón, M., Barrón-Andrés, B., Bascuñana, J., Blanco-Molina, A., Cañas, I., Casado, I., Chic, N., Del Pozo, R., Del Toro, J., Díaz-Pedroche, M.C., Díaz-Peromingo, J.A., Falgá, C., Fernández-Aracil, C., Fernández-Capitán, C., Fidalgo, M.A., Font, C., Font, L., Gallego, P., García, M.A., García-Bragado, F., Gavín, O., Gómez, C., Gómez, V., González, J., Grau, E., Grimón, A., Guijarro, R., Guirado, L., Gutiérrez, J., Hernández-Comes, G., Hernández-Blasco, L., Jara-Palomares, L., Jaras, M.J., Jiménez, D., Jiménez, J., Joya, M.D., Llamas, P., Lobo, J.L., López, P., López-Jiménez, L., López-Reyes, R., López-Sáez, J.B., Lorente, M.A., Lumbierres, M., Luque, J.M., Marchena, P.J., Martín-Martos, F., Mellado, M., Nieto, S., Núñez, A., Núñez, M.J., Otalora, S., Otero, R., Pedrajas, J.M., Pérez, G., Pérez-Ductor, C., Peris, M.L., Pons, I., Porras, J.A., Reig, O., Riera-Mestre, A., Riesco, D., Rivas, A., Rodríguez, M., Rodríguez-Dávila, M.A., Rosa, V., Rosillo-Hernández, E., Ruiz-Artacho, P., Ruiz-Giménez, N., Sahuquillo, J.C., Sala-Sainz, M.C., Sánchez-Martínez, R., Sanz, O., Soler, S., Sopeña, B., Suriñach, J.M., Tolosa, C., Torres, M.I., Troya, J., Trujillo-Santos, J., Uresandi, F., Usandizaga, E., Valle, R., Vela, J., Vela, L., Vicente, M.P., Xifre, B., Vanassche, T., Verhamme, P., Yoo, H., Hirmerova, J., Dulíček, P., Salgado, E., Bura-Riviere, A., Farge-Bancel, D., Hij, A., Mahé, I., Merah, A., Braester, A., Antonucci, G., Barillari, G., Bilora, F., Bortoluzzi, C., Brandolin, B., Cattabiani, C., Ciammaichella, M., Dell'Elce, N., Dentali, F., Duce, R., Grandone, E., Imbalzano, E., Lessiani, G., Maida, R., Mastroiacovo, D., Pace, F., Parisi, R., Pellegrinet, M., Pesavento, R., Pinelli, M., Poggio, R., Quintavalla, R., Rocci, A., Tiraferri, E., Tonello, D., Tufano, A., Visonà, A., Gibietis, V., Skride, A., Vitola, B., Zdraveska, M., Mazzolai, L., Moustafa, F., Giorgi Pierfranceschi, M., Di Micco, P., Bucherini, E., Lorenzo, A., Villalobos, A., Nieto, J. A., Valero, B., Samperiz, A. L., Monreal, M., Maly, R., Adarraga, M. D., Aibar, M. A., Arcelus, J. I., Barron, M., Barron-Andres, B., Bascunana, J., Canas, I., del Pozo, R., del Toro, J., Diaz-Pedroche, M. C., Diaz-Peromingo, J. A., Falga, C., Fernandez-Aracil, C., Fernandez-Capitan, C., Fidalgo, M. A., Garcia, M. A., Garcia-Bragado, F., Gavin, O., Gomez, C., Gomez, V., Gonzalez, J., Grimon, A., Gutierrez, J., Hernandez-Comes, G., Hernandez-Blasco, L., Jaras, M. J., Jimenez, D., Jimenez, J., Joya, M. D., Lobo, J. L., Lopez, P., Lopez-Jimenez, L., Lopez-Reyes, R., Lopez-Saez, J. B., Lorente, M. A., Luque, J. M., Marchena, P. J., Martin-Martos, F., Nunez, A., Nunez, M. J., Pedrajas, J. M., Perez, G., Perez-Ductor, C., Peris, M. L., Porras, J. A., Rodriguez, M., Rodriguez-Davila, M. A., Rosillo-Hernandez, E., Ruiz-Gimenez, N., Sahuquillo, J. C., Sala-Sainz, M. C., Sanchez-Martinez, R., Sopena, B., Surinach, J. M., Torres, M. I., Vicente, M. P., Yoo, H. H. B., Dulicek, P., Mahe, I., and Visona, A.
Subjects: medicine.medical_specialty, Gastrointestinal bleeding, anticoagulants, recurrence, venous thromboembolism, hemorrhage, mortality, recurrences, Renal function, 030204 cardiovascular system & hematology, Lower risk, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, 030212 general & internal medicine, business.industry, anticoagulant, Retrospective cohort study, Hematology, Odds ratio, medicine.disease, Confidence interval, Surgery, Natural history, Original Article, business, Original Articles: Thrombosis
Abstract: Essentials Recent randomized trials suggested fewer bleeding events in fragile patients with VTE receiving DOACs.The frequency, clinical characteristics and outcome of these patients have not been reported in real life.Fragile patients with VTE had a higher risk for major bleeding or death and a lower risk for recurrences than non‐fragile. Background Subgroup analyses from randomized trials suggested favorable results for the direct oral anticoagulants in fragile patients with venous thromboembolism (VTE). The frequency and natural history of fragile patients with VTE have not been studied yet. Objectives To compare the clinical characteristics, treatment and outcomes during the first 3 months of anticoagulation in fragile vs non‐fragile patients with VTE. Methods Retrospective study using consecutive patients enrolled in the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry. Fragile patients were defined as those having age ≥75 years, creatinine clearance (CrCl) levels ≤50 mL/min, and/or body weight ≤50 kg. Results From January 2013 to October 2016, 15 079 patients were recruited. Of these, 6260 (42%) were fragile: 37% were aged ≥75 years, 20% had CrCl levels ≤50 mL/min, and 3.6% weighed ≤50 kg. During the first 3 months of anticoagulant therapy, fragile patients had a lower risk of VTE recurrences (0.78% vs 1.4%; adjusted odds ratio [OR]: 0.52; 95% confidence intervals [CI]: 0.37‐0.74) and a higher risk of major bleeding (2.6% vs 1.4%; adjusted OR: 1.41; 95% CI: 1.10‐1.80), gastrointestinal bleeding (0.86% vs 0.35%; adjusted OR: 1.84; 95% CI: 1.16‐2.92), haematoma (0.51% vs 0.07%; adjusted OR: 5.05; 95% CI: 2.05‐12.4), all‐cause death (9.2% vs 3.5%; adjusted OR: 2.02; 95% CI: 1.75‐2.33), or fatal PE (0.85% vs 0.35%; adjusted OR: 1.77; 95% CI: 1.10‐2.85) than the non‐fragile. Conclusions In real life, 42% of VTE patients were fragile. During anticoagulation, they had fewer VTE recurrences and more major bleeding events than the non‐fragile.
Published: 2017

11. Vitamin K Antagonists After 6 Months of Low-Molecular-Weight Heparin in Cancer Patients with Venous Thromboembolism

Author: Chatree Chai-Adisaksopha, Alfonso Iorio, Mark A. Crowther, Javier de Miguel, Estuardo Salgado, Marija Zdraveska, Carmen Fernández-Capitán, José Antonio Nieto, Giovanni Barillari, Laurent Bertoletti, Manuel Monreal, M.A. Aibar, J.I. Arcelus, A. Ballaz, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, T. Bueso, B. Calvo, G. Cañada, I. Cañas, I. Casado, A. Culla, J. de Miguel, J. del Toro, J.A. Díaz-Peromingo, C. Falgá, C. Fernández-Capitán, C. Font, L. Font, P. Gallego, F. García-Bragado, V. Gómez, J. González, E. Grau, M. Guil, L. Guirado, J. Gutiérrez, G. Hernández, L. Hernández-Blasco, V. Isern, L. Jara-Palomares, M.J. Jaras, D. Jiménez, B. Lacruz, R. Lecumberri, J.L. Lobo, L. López-Jiménez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, I. Manrique-Abos, P.J. Marchena, J.M. Martín-Antorán, F. Martín-Martos, M. Monreal, M.V. Morales, R. Morillo, D. Nauffal, J.A. Nieto, S. Nieto, M.J. Núñez, M. Odriozola, S. Otalora, R. Otero, B. Pagán, J.M. Pedrajas, C. Pérez, M.L. Peris, I. Pons, J.A. Porras, L. Ramirez, A. Riera, A. Rivas, C. Rodríguez, M.A. Rodríguez-Dávila, V. Rosa, N. Ruiz-Giménez, A. Sampériz, R. Sánchez, M.C. Sala, J.C. Sahuquillo, O. Sanz, S. Soler, I. Suárez-González, J.M. Suriñach, G. Tiberio, C. Tolosa, J. Trujillo-Santos, F. Uresandi, B. Valero, R. Valle, J. Vela, M.P. Vicente, G. Vidal, V. Vilella-Tomás, J. Villalta, P.C. Malfante, T. Vanassche, P. Verhamme, P. Wells, J. Hirmerova, R. Malý, T. Tomko, G. Celis, E. Salgado, G.T. Sánchez, L. Bertoletti, A. Bura-Riviere, D. Farge-Bancel, A. Hij, I. Mahé, A. Merah, I. Quere, M. Papadakis, A. Braester, B. Brenner, I. Tzoran, A. Apollonio, G. Barillari, A. Bertone, F. Bilora, E. Bucherini, G. Candelero, M. Ciammaichella, P. Di Micco, P. Ferrazzi, E. Grandone, G. Lessiani, C. Lodigiani, D. Mastroiacovo, F. Pace, R. Pesavento, M. Pinelli, P. Prandoni, M. Rosa, L. Rota, E. Tiraferri, D. Tonello, A. Tufano, U. Venturelli, A. Visonà, B. Zalunardo, E. Drucka, D. Kigitovica, A. Skride, M.S. Sousa, M. Bosevski, M. Zdraveska, H. Bounameaux, L. Mazzolai, and J.C. Serrano
Subjects: Male, medicine.medical_specialty, Vitamin K, medicine.drug_class, Deep vein, Low molecular weight heparin, Anticoagulants, Cancer, Low-molecular-weight heparin, Thromboembolism, Warfarin, 030204 cardiovascular system & hematology, Recurrent deep vein thrombosis, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Neoplasms, medicine, Humans, Registries, Propensity Score, Aged, Retrospective Studies, business.industry, Retrospective cohort study, General Medicine, Venous Thromboembolism, Heparin, Low-Molecular-Weight, medicine.disease, Thrombosis, Pulmonary embolism, Surgery, Venous thrombosis, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, business, medicine.drug
Abstract: BACKGROUND: Low-molecular-weight heparin (LMWH) is the treatment of choice in cancer patients with venous thromboembolism. However, data on continuing LMWH treatment beyond 6 months remain scanty. METHODS: We used the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to compare the rate of venous thromboembolism recurrences and major bleeding appearing beyond the first 6 months of anticoagulant therapy in cancer patients with venous thromboembolism, according to therapy with LMWH or vitamin K antagonists (VKA). We performed a propensity score-matched cohort study. RESULTS: After propensity matching, 482 cancer patients continued to receive LMWH and 482 switched to VKA. During the course of anticoagulant therapy (mean 275.5 days), 57 patients developed venous thrombosis recurrences (recurrent pulmonary embolism 26, recurrent deep vein thrombosis 29, both 2), 28 had major bleeding, 38 had nonmajor bleeding, and 129 died. No patient died of recurrent venous thrombosis, and 5 patients died of bleeding (2 were on LMWH, 3 on VKA). Patients who continued with LMWH had a similar rate of deep vein thrombosis recurrences (relative risk [RR] 1.41; 95% confidence interval [CI], 0.68-2.93), pulmonary embolism recurrences (RR 0.73; 95% CI, 0.34-1.58), major bleeding (RR 0.96; 95% CI, 0.51-1.79), or nonmajor bleeding (RR 1.15; 95% CI, 0.55-2.40), compared with those who switched to VKA, but a higher mortality rate (RR 1.58; 95% CI, 1.13-2.20). CONCLUSIONS: In cancer patients with venous thromboembolism who completed 6 months of LMWH therapy, switching to VKA was associated with a similar risk of venous thrombosis recurrences or bleeding when compared with patients who continued LMWH. (C) 2018 Elsevier Inc. All rights reserved.
Published: 2017

12. Analysis of noncatheter-associated upper extremity deep venous thrombosis from the RIETE registry

Author: C. Pérez-Ductor, Raffaele Pesavento, Barry M. Brenner, Silvia Soler, Paolo Prandoni, Luciano López-Jiménez, Pierpaolo Di Micco, S. Nieto, Renzo Poggio, Inna Tzoran, T. Bueso, Alicia Lorenzo, Carmen Fernández-Capitán, F. García-Bragado, D. Riesco, Thomas Vanassche, M. Papadakis, J. del Toro, N. Ruiz-Giménez, M.J. Núñez, F. Martín-Martos, Mark M. Levy, Benjamin Brenner, J.A. Porras, G. Vidal, V. Gómez, A. Braester, Cristina Perez Ductor, R. Barba, R. Valle, Bernardo Sopeña, Lidia Luciana Rota, J.C. Sahuquillo, E. Tiraferri, J.M. Martín-Antorán, M.S. Sousa, Conxita Falga, Jose Gutierrez, Ángeles Blanco-Molina, J.M. Suriñach, H. Bounameaux, Isabelle Mahé, María del Carmen Díaz-Pedroche, Philip S. Wells, B. Pagán, Agustina Rivas, J. Bascuñana, G. Antonucci, Carme Font, Antonella Tufano, Maurizio Ciammaichella, S. Otalora, Ángel Sampériz, J. González, R. Maida, Giovanni Barillari, Andris Skride, P. Di Micco, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, F. Pace, Diego Tonello, Remedios Otero, R. Malý, L. Bertoletti, R. Lecumberri, M.A. Aibar, K. Champion, D. Kigitovica, J. Binetti, M.L. Peris, M.A. Rodríguez-Dávila, Adriana Visonà, L. Guirado, Miguel Martín, Abílio Reis, P. Gallego, O. Reig, G. Pérez, Hervé Decousus, Daniel H. Newton, E. Salgado, P. Prandoni, Laurent Bertoletti, Peter Verhamme, Luke G. Wolfe, Javier Trujillo-Santos, M.A. García, M.A. Fidalgo, Paola Ferrazzi, Pablo Javier Marchena, J. Villalta, M.A. Lorente, Elvira Grandone, O. Sanz, M.C. Sala-Sainz, F. Bilora, M. Bosevski, I. Cañas, Vladimir Rosa, David Jiménez, Juan I. Arcelus, E. Grau, B. Zalunardo, Beatriz Valero, Luis Jara-Palomares, Manuel Monreal Bosch, José María Pedrajas, Pedro Ruiz-Artacho, B. Barrón-Andrés, Fernando Uresandi, E. Rosillo-Hernández, M.D. Joya, Rita Duce, L. Font, C. Tolosa, Francesco Dentali, I. Manrique-Abos, F. Carmona, Andreas Erdmann, Antoni Riera-Mestre, L. Hernández-Blasco, Nuria Chic, J.B. López-Sáez, J. Vela, J. Hirmerova, A. Grimón, G. Hernández-Comes, D. Farge-Bancel, C. Fernández-Aracil, Raquel López-Reyes, Raúl Sánchez, Michael F. Amendola, J.A. Nieto, A. Merah, I. Tzoran, J.L. Ribeiro, E. Drucka, Lucia Mazzolai, Radovan Malý, María Belén Alfonso, José Luis Lobo, M. Zdraveska, I. Pérez, Marijan Bosevski, Manolis Papadakis, Raquel Barba, R. Aranda, A.R. Ramos, R. del Pozo, M. Barrón, A. Hij, R. Agüero, Ramón Lecumberri, Corrado Lodigiani, Henri Bounameaux, A. Culla, A. Núñez, J.A. Díaz-Peromingo, and Barbara Ney
Subjects: Adult, Male, medicine.medical_specialty, Multivariate analysis, Adolescent, Hemorrhage, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Catheterization, Peripheral, 03 medical and health sciences, Immobilization, Young Adult, 0302 clinical medicine, Recurrence, Aged, Aged, 80 and over, Catheterization, Peripheral, Female, Humans, Middle Aged, Neoplasms, Pulmonary Embolism, Registries, Upper Extremity Deep Vein Thrombosis, Venous Thromboembolism, 80 and over, Medicine, cardiovascular diseases, Young adult, Prospective cohort study, business.industry, Odds ratio, medicine.disease, Thrombosis, Confidence interval, Surgery, Pulmonary embolism, Venous thrombosis, 030228 respiratory system, Cardiology and Cardiovascular Medicine, business
Abstract: We sought to determine the risk factors for subsequent bleeding and recurrent venous thromboembolism (VTE) events following isolated noncatheter-associated upper extremity deep venous thrombosis (non-CA-UEDVT) to better inform future treatment decisions for this group of patients.The RIETE registry (Registro Informatizado de Enfermedad TromboEmbólica [Computerized Registry of Patients with Venous Thromboembolism]) is a prospective international registry of patients with objectively confirmed symptomatic VTE. Patients with a symptomatic, isolated, proximal UEDVT from March 2001 through March 2015 were analyzed. Any patient with an indwelling catheter or pacemaker lead at the DVT site and at the time of thrombosis was considered to have a CA-UEDVT and was excluded. Patient and treatment characteristics such as age, gender, comorbidities, VTE risk factors, treatment drug, and duration were collected. Outcomes examined included recurrent DVT, subsequent pulmonary embolism (PE), and hemorrhage. Multivariate analysis was performed using stepwise logistic regression.Of the 1100 patients who met the study criteria, 580 (53%) were male. The mean age of the patients was 50 ± 20 years, and overall patient survival at 1 year was 85%. Recurrent VTE occurred in 59 patients (5.4%). Of these, 46 patients (4%) had recurrent DVT, 10 (0.9%) had a PE following UEDVT diagnosis, and 3 (0.3%) had both. PE was fatal in three patients (0.3%). Bleeding occurred in 50 patients (4.5%), major bleeding in 19 patients (1.7%), and fatal bleeding in 6 patients (0.5%). On multivariate analysis, malignant disease was associated with VTE recurrence (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.04-3.45; P .04), whereas hemorrhage was associated with age (OR, 1.03; 95% CI, 1.01-1.05; P = .002) and malignant disease (OR, 2.53; 95% CI, 1.34-4.76; P .005). Hemorrhage and recurrent VTE were also significantly associated (OR, 2.79; 95% CI, 1.16-6.76; P .03).PE following non-CA-UEDVT is rare. Malignant disease was associated with VTE recurrence. Age and malignant disease were associated with hemorrhage, and VTE recurrence was associated with hemorrhage. Further prospective studies should be undertaken to best determine length of anticoagulation treatment for the varied populations of patients with UEDVT.
Published: 2017

13. Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism

Author: Deisy Barrios, Jeremy Chavant, David Jiménez, Laurent Bertoletti, Vladimir Rosa-Salazar, Alfonso Muriel, Alain Viallon, Carmen Fernández-Capitán, Roger D. Yusen, Manuel Monreal, Hervè Decousus, Paolo Prandoni, Benjamin Brenner, Raquel Barba, Pierpaolo Di Micco, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Philip Wells, Peter Verhamme, M.D. Adarraga, M.A. Aibar, M. Alfonso, J.I. Arcelus, P.M. Azcarate-Agüero, A. Ballaz, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, G. Cañada, I. Cañas, I. Casado, N. Chic, R. del Pozo, J. del Toro, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, C. Falgá, C. Fernández-Aracil, C. Fernández-Capitán, M.A. Fidalgo, C. Font, L. Font, P. Gallego, M.A. García, F. García-Bragado, P. García-Brotons, O. Gavín, C. Gómez, V. Gómez, J. González, E. Grau, A. Grimón, L. Guirado, J. Gutiérrez, G. Hernández-Comes, L. Hernández-Blasco, L. Jara-Palomares, M.J. Jaras, D. Jiménez, J. Jiménez, M.D. Joya, P. Llamas, J.L. Lobo, P. López, L. López-Jiménez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, J.M. Luque, P.J. Marchena, C. Martínez, F. Martín-Martos, M. Monreal, J.A. Nieto, S. Nieto, A. Núñez, M.J. Núñez, S. Otalora, R. Otero, J.M. Pedrajas, G. Pérez, C. Pérez-Ductor, M.L. Peris, I. Pons, J.A. Porras, O. Reig, A. Riera-Mestre, D. Riesco, A. Rivas, M. Rodríguez, M.A. Rodríguez-Dávila, V. Rosa, J.C. Sahuquillo, M.C. Sala-Sainz, A. Sampériz, R. Sánchez-Martínez, O. Sanz, S. Soler, B. Sopeña, J.M. Suriñach, C. Tolosa, M.I. Torres, J. Trujillo-Santos, F. Uresandi, E. Usandizaga, B. Valero, R. Valle, J. Vela, G. Vidal, C. Vilar, B. Xifre, T. Vanassche, P. Verhamme, H.H.B. Yoo, P. Wells, J. Hirmerova, R. Malý, E. Salgado, L. Bertoletti, A. Bura-Riviere, D. Farge-Bancel, A. Hij, I. Mahé, A. Merah, F. Moustafa, A. Braester, B. Brenner, I. Tzoran, G. Antonucci, G. Barillari, F. Bilora, A. Bonanome, C. Bortoluzzi, B. Brandolin, M. Ciammaichella, P. De Ciantis, F. Dentali, P. Di Micco, R. Duce, M. Giorgi-Pierfranceschi, E. Grandone, E. Imbalzano, G. Lessiani, R. Maida, D. Mastroiacovo, F. Pace, R. Parisi, R. Pesavento, M. Pinelli, R. Poggio, P. Prandoni, R. Quintavalla, A. Rocci, E. Tiraferri, D. Tonello, A. Tufano, U. Venturelli, A. Visonà, V. Gibietis, A. Skride, B. Vitola, M. Bosevski, M. Zdraveska, H. Bounameaux, and L. Mazzolai
Subjects: Male, medicine.medical_specialty, Heart Diseases, medicine.medical_treatment, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, 03 medical and health sciences, Anticoagulation, 0302 clinical medicine, Reperfusion therapy, Recurrence, Internal medicine, Cause of Death, medicine, Humans, Thrombolytic Therapy, 030212 general & internal medicine, Propensity Score, Cause of death, Right heart thrombi, Aged, business.industry, Pulmonary embolism, Anticoagulants, Thrombosis, General Medicine, Thrombolysis, Middle Aged, medicine.disease, Confidence interval, Treatment, Treatment Outcome, Propensity score matching, Cardiology, Female, business, Pulmonary Embolism
Abstract: Background Evidence-based recommendations do not adequately address the treatment of right heart thrombi in patients who present with acute symptomatic pulmonary embolism. Methods This study included patients who had acute pulmonary embolism associated with right heart thrombi and participated in the Registro Informatizado de la Enfermedad TromboEmbolica registry. We assessed the effectiveness of anticoagulation versus reperfusion treatment for the outcomes of all-cause mortality, pulmonary embolism–related mortality, recurrent venous thromboembolism, and major bleeding rates through 30 days after initiation of pulmonary embolism treatment. We used propensity score matching to adjust for the likelihood of receiving reperfusion treatment. Results Of 325 patients with pulmonary embolism and right heart thrombi, 255 (78%; 95% confidence interval, 74-83) received anticoagulation and 70 (22%; 95% confidence interval, 17-26) also received reperfusion treatment. Propensity score–matched pairs analyses did not detect a statistically lower risk of all-cause death (6.2% vs 14%, P = .15) or pulmonary embolism–related mortality (4.7% vs 7.8%; P = .47) for reperfusion compared with anticoagulation. Of the patients who received reperfusion treatment, 6.2% had a recurrence during the study follow-up period, compared with 0% of those who received anticoagulation ( P = .049). The incidence of major bleeding events was not statistically different between the 2 treatment groups (3.1% vs 3.1%; P = 1.00). Conclusions In patients with pulmonary embolism and right heart thrombi, no significant difference was found between reperfusion therapy and anticoagulant therapy for mortality and bleeding. The risk of recurrences was significantly higher for reperfusion therapy compared with anticoagulation. Right heart thrombi may not warrant riskier interventions than standard anticoagulation.
Published: 2017

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

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

15. DVT Management and Outcome Trends, 2001 to 2014

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

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

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

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

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

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

Author: A. Hij, C. Piovella, Ramón Lecumberri, José Luis Lobo, M. Zdraveska, F.J. Muñoz, F. Valle, Marijan Bosevski, P. Verhamme, N. Ruiz-Giménez, Olga Madridano, Steven Greenberg, A. Apollonio, J.F. Benítez, J.A. Porras, R. Maida, L. Bertoletti, G. Pérez-Rus, P. Román, R. Malý, M.J. Soto, J.M. Suriñach, H. Bounameaux, S. Pasca, J. González, B. Zalunardo, A. Merah, J. Caprini, J. Gutiérrez, I. Tzoran, M. Ciammaichella, A. García, Alicia Lorenzo, Manuel Monreal Bosch, R. Re, Abílio Reis, R. Valle, Lucia Mazzolai, M. Alcalde, Laurent Bertoletti, Peter Verhamme, Diego Tonello, J.B. López-Sáez, Juan I. Arcelus, Vladimir Rosa, D. Farge-Bancel, Isabelle Quéré, V. Vilella-Tomas, R. Jiménez, José María Pedrajas, J.M. Martín-Antorán, O. Sanz, P. Malfante, David Jiménez, L. López-Montes, B. Pagán, Inna Tzoran, J. Bascuñana, Beatriz Valero, E. Grau, Adriana Visonà, Francisco José Muñoz, M. Gómez-Durán, R. Guijarro, Antonella Tufano, A. Guida, J. Villalta, Luca Calanca, M.A. Lorente, M.J. Núñez, F. Conget, Lauren Cote, F. del Molino, M. Barrón, L. Rota, P. Prandoni, A. Braester, Raquel Barba, Radovan Malý, Ajla Alibalic, J. del Toro, I. Pons, Luis Jara-Palomares, B. Barrón-Andrés, Javier Trujillo-Santos, Fernando Uresandi, F. García-Bragado, P. Gallego, J. Malheiro, J. Vela, Henri Bounameaux, S. Hernández-Huerta, L. Hernández, P. Ferrazzi, Thomas Vanassche, Agustina Rivas, Giovanni Barillari, Farès Moustafa, J.A. Díaz, Ángeles Blanco-Molina, Pablo Javier Marchena, Benjamin Brenner, J. Hirmerova, M. Monreal, Raúl Sánchez, Aurora Villalobos, M.V. Morales, P. Di Micco, V. Gómez, Bernardo Sopeña, Ángel Sampériz, Antoni Riera-Mestre, Raquel López-Reyes, L. Font, M. Bosevski, Philip S. Wells, Joseph A. Caprini, I. Casado, R. Tirado, R. Barba, M.S. Sousa, Conxita Falga, J.A. Nieto, Remedios Otero, Lisa Baumann Kreuziger, Hervé Decousus, J.L. Ribeiro, G. Tiberio, M.L. Peris, M.A. Rodríguez-Dávila, A. Alatri, Isabelle Mahé, F. Pace, Luciano López-Jiménez, Sebastian Schellong, Carmen Fernández-Capitán, P. Sabio, Manuel Monreal, M.J. Jaras, Alessandra Bura-Rivière, F. Martín-Martos, S. Jiménez, Teresa Auguet, M. Macià, Dolores Nauffal, Barry M. Brenner, Silvia Soler, Paolo Prandoni, Pierpaolo Di Micco, J.C. Serrano, 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: medicine.medical_specialty, Catheters, Hemorrhage, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Recurrent thromboembolism, medicine, Humans, Registries, Risk factor, Venous Thrombosis, business.industry, Thrombosis, Odds ratio, medicine.disease, 3. Good health, Surgery, Pulmonary embolism, Catheter, Venous thrombosis, 030220 oncology & carcinogenesis, Concomitant, Pulmonary Embolism, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; BACKGROUND:Few studies have investigated the treatment and the outcomes of patients with catheter-related thrombosis (CRT).METHODS:The RIETE registry (Registro Informatizado de Enfermedad TromboEmbólica [Computerized Registry of Patients with Venous Thromboembolism]) is a prospective international registry of consecutive patients with objectively confirmed venous thromboembolism (VTE). We analyzed the characteristics, treatment, and outcomes of patients with CRT.RESULTS:Of 558 patients with CRT, 45 (8%) presented with a pulmonary embolism (PE) concomitantly. More patients had central line-associated thrombosis compared with port systems, but catheter type did not influence the risk of presenting with a PE. Patients with only CRT were more often prescribed low-molecular-weight heparin for the duration of their anticoagulant treatment compared with patients presenting with concomitant PE. VTE recurrences and major bleeding events occurred frequently during treatment with anticoagulation (7 per 100 patient-years and 8.9 per 100 patient years, respectively). The rates of fatal PE recurrences (1.85 per 100 patient-years) and fatal bleeding (2.32 per 100 patient-years) were similar. Patients with an additional transient risk factor for VTE had the lowest risk for VTE recurrences (odds ratio [OR], 0.07; 90% confidence interval [CI], 0.01-0.45) compared with patients with CRT and no additional transient risk factors. PE at presentation increased the risk of recurrent thrombosis by 2.4 times. Renal insufficiency was also an independent predictor of recurrent thrombosis (OR, 3.93; 90% CI, 2.0-7.7). The odds of recurrent thrombosis was decreased by 77% in patients who received anticoagulation therapy for >90 days compared with patients with a shorter treatment (OR, 0.23; 90% CI, 0.1-0.56).CONCLUSIONS:Concomitant PE occurs less frequently in CRT than lower extremity deep venous thrombosis, but it is associated with a worse outcome. CRT occurs in high-risk patients, and duration of anticoagulation must be predicated on balancing these risks.
Published: 2015

19. A prognostic score to identify women at increased risk for abnormal uterine bleeding during anticoagulation for venous thromboembolism

Author: Gabrielle Sarlon-Bartoli, Juan Criado, Saskia Middeldorp, José Antonio Nieto, María del Carmen Díaz-Pedroche, Farès Moustafa, Nuria Ruiz-Giménez, Benjamin Brenner, Manuel Monreal, Pierpaolo DI Micco, Paolo Prandoni, Dominique Farge-Bancel, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abilio Reis, Marijan Bosevski, Henri Bounameaux, Radovan Malý, Peter Verhamme, Joseph A. Caprini, Hanh My Bui, M.D. Adarraga, P. Agudo, C. Amado, J.I. Arcelus, A. Ballaz, J. Bascuñana, R. Barba, C. Barbagelata, M. Barrón, B. Barrón-Andrés, A. Blanco-Molina, F. Beddar Chaib, E. Botella, I. Cañas, R. Carrero-Arribas, I. Casado, P. Cerdá, L. Chasco, J. Criado, C. de Ancos, J. de Miguel, J. del Toro, P. Demelo-Rodríguez, A.M. Díaz-Brasero, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, I.M. Domínguez, A. Dubois-Silva, J.C. Escribano, F. Espósito, A.I. Farfán-Sedano, C. Falgá, C. Fernández-Capitán, B. Fernández-Jiménez, J. Fernández-Muixi, J.L. Fernández-Reyes, C. Font, I. Francisco, F. Galeano-Valle, M.A. García, F. García-Bragado, M. García de Herreros, O. Gavín-Blanco, A. Gil-Díaz, C. Gómez-Cuervo, A.M. Gómez-Mosquera, M. Gonzalez-Moreno, E. Grau, L. Guirado, J. Gutiérrez, L. Hernández-Blasco, L. Jara-Palomares, M.J. Jaras, D. Jiménez, I. Jou, M.D. Joya, B. Lacruz, S. Lainez-Justo, Latorre A, Lima J, Lobo Jl, M. López-De la Fuente, L. López-Jiménez, M. López-Meseguer, P. López-Miguel, J.J. López-Núñez, R. López-Reyes, J.B. López-Sáez, M.A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, P.J. Marchena, J.M. Martín-Guerra, F. Martín-Martos, M. Mellado, E. Mena, J. Moisés, M.I. Mercado, M. Monreal, A. Muñoz-Blanco, G. Muñoz-Gamito, M.V. Morales, J.A. Nieto, E. Noguera-Gras, M.J. Núñez-Fernández, M. Olid-Velilla, J. Osorio, S. Otalora, R. Otero, D. Paredes-Ruiz, P. Parra, V. Parra, J.M. Pedrajas, M. Pérez-López, M.L. Peris, M.L. Pesce, J.A. Porras, J. Poyo-Molina, R. Puchades, A. Riera-Mestre, F. Rivera-Civico, A. Rivera-Gallego, M. Roca, V. Rosa, A. Rodríguez-Cobo, C. Rodríguez-Matute, P. Ruiz-Artacho, N. Ruiz-Giménez, J. Ruiz-Ruiz, G. Salgueiro, T. Sancho, V. Sendín, P. Sigüenza, S. Soler, B. Suárez-Rodríguez, J.M. Suriñach, G. Tiberio, M.I. Torres, A. Torres-Sánchez, J. Trujillo-Santos, F. Uresandi, E. Usandizaga, R. Valle, J.F. Varona, L. Vela, J.R. Vela, A. Villalobos, P. Villares, C. Ay, S. Nopp, I. Pabinger, M.M. Engelen, C. Martens, P. Verhamme, H.H.B. Yoo, J.D. Arguello, A.C. Montenegro, J. Roa, J. Hirmerova, R. Malý, S. Accassat, L. Bertoletti, A. Bura-Riviere, J. Catella, R. Chopard, F. Couturaud, O. Espitia, S. El Harake, R. Le Mao, I. Mahé, F. Moustafa, L. Plaisance, G. Sarlon-Bartoli, P. Suchon, E. Versini, S. Schellong, A. Braester, B. Brenner, G. Kenet, I. Tzoran, P. Sadeghipour, M. Basaglia, F. Bilora, C. Bortoluzzi, B. Brandolin, M. Ciammaichella, A. De Angelis, F. Dentali, P. Di Micco, E. Imbalzano, S. Merla, R. Pesavento, P. Prandoni, C. Siniscalchi, A. Tufano, A. Visonà, N. Vo Hong, B. Zalunardo, D. Kigitovica, E. Rusa, A. Skride, S. Fonseca, M. Manuel, J. Meireles, M. Bosevski, A. Eftimova, M. Zdraveska, H. Bounameaux, L. Mazzolai, A. Aujayeb, J.A. Caprini, I. Weinberg, and H.M. Bui
Subjects: Anticoagulants, Venous thromboembolism, Uterine bleeding, Prognostic score, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Introduction: Little is known about the clinical characteristics of women at increased risk for abnormal uterine bleeding (UB) during anticoagulation for venous thromboembolism (VTE). Methods: We used the RIETE registry to identify the baseline characteristics of women developing abnormal UB during anticoagulation. We used logistic regression analysis to identify independent predictors for abnormal UB. Then, we built a prognostic score to identify at-risk women. Results: From March 2001 through October 2022, there were 54,372 women with VTE. During anticoagulation (median, 181 days), 318 (0.6%) developed abnormal UB (major bleeding = 88, clinically relevant non-major (CRNM) = 230). On multivariable analysis, women aged 70 kg, with uterine cancer, recent UB, anemia, estrogen-related VTE, or receiving rivaroxaban or apixaban were at increased risk for abnormal UB. Using the prognostic score, 42,273 women (78%) were at low-risk, 8,828 (16%) intermediate-, and 3,271 (6.1%) at high-risk for abnormal UB. Their rates of abnormal UB were: 0.28 (95%CI: 0.23–0.35), 1.32 (95%CI: 1.07–1.61) and 7.12 (95%CI: 5.98–8.41) bleeds per 100 patient-years, respectively. The c-statistic was 0.80 (95%CI: 0.77–0.83). The rates of major UB were: 0.06 (95%CI: 0.04–0.09), 0.43 (95%CI: 0.30–0.60) and 1.85 (95%CI: 1.31–2.53) per 100 patient-years, respectively (c-statistic: 0.84; 95%CI: 0.80–0.89). The rates of CRNM uterine bleeding were: 0.21 (95%CI: 0.17–0.26), 0.85 (95%CI: 0.65–1.08), and 5.02 (95%CI: 4.09–6.10) bleeds per 100 patient-years, respectively (c-statistic: 0.78; 95%CI: 0.75–0.82). Conclusions: Using 7 variables easily available at admission, we built a prognostic score that reliably identified women with VTE at increased risk for abnormal UB during anticoagulation.
Published: 2023
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20. Gender differences in patients with venous thromboembolism and five common sites of cancer.

Author: Martín-Martos F, Trujillo-Santos J, Del Toro J, Bura-Riviere A, Lorenzo A, Barillari G, Soler S, Mahè I, Sahuquillo JC, and Monreal M
Subjects: Aged, Aged, 80 and over, Anticoagulants adverse effects, Female, Hemorrhage chemically induced, Heparin, Low-Molecular-Weight adverse effects, Humans, Male, Middle Aged, Neoplasms mortality, Recurrence, Sex Factors, Treatment Outcome, Venous Thromboembolism mortality, Venous Thromboembolism pathology, Anticoagulants therapeutic use, Heparin, Low-Molecular-Weight therapeutic use, Neoplasms complications, Venous Thromboembolism drug therapy, Venous Thromboembolism epidemiology
Abstract: Background: The outcome of cancer patients with venous thromboembolism (VTE) may differ according to gender., Methods: We used the RIETE database to compare the rate of VTE recurrences, major bleeding and mortality in patients with lung, colorectal, pancreatic, hematologic or gastric cancer during the course of anticoagulation, according to gender., Results: As of January 2016, 11,055 patients with active cancer were enrolled: 1,727 had lung cancer, 1,592 colorectal, 840 hematologic, 517 pancreatic and 459 had gastric cancer. Compared with men (N = 3,130), women (N = 2,005) were more likely to have colorectal, pancreatic or hematologic cancer, and less likely to have lung cancer. Most patients (91%) were initially treated with low-molecular-weight heparin (LMWH), but women received higher daily doses per body weight. Then, 66% kept receiving LMWH for long-term therapy. During the course of anticoagulation, 302 patients developed recurrent VTE, 220 bled and 1,749 died. Compared with men, women had a similar rate of VTE recurrences or major bleeding, and a lower mortality (risk ratio [RR]: 0.90; 95% CI: 0.82-0.99). When separately comparing outcomes according to cancer site, women with lung cancer had a lower mortality (RR: 0.79; 95% CI: 0.70-0.92), those with colorectal cancer had a higher mortality (RR: 1.25; 95% CI: 1.02-1.54) and those with gastric cancer had a higher rate of VTE recurrences than men (RR: 2.47; 95% CI: 1.04-5.89)., Conclusions: VTE women with lung, colorectal, pancreatic, haematological or gastric cancer experienced a similar outcome during the course of anticoagulant therapy than men with similar cancers., (© 2017 Elsevier Ltd. All rights reserved.)
Published: 2017
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21. Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism: Findings from the RIETE Registry.

Author: Barillari G, Londero AP, Brenner B, Nauffal D, Muñoz-Torrero JF, Del Molino F, Moustafa F, Madridano O, Martín-Martos F, and Monreal M
Subjects: Adult, Anticoagulants therapeutic use, Cohort Studies, Female, Fibrinolytic Agents therapeutic use, Humans, Incidence, Mortality, Pregnancy, Pregnancy Complications, Cardiovascular therapy, Prevalence, Prospective Studies, Puerperal Disorders therapy, Pulmonary Embolism therapy, Recurrence, Vena Cava Filters, Venous Thromboembolism therapy, Venous Thrombosis therapy, Hemorrhage epidemiology, Pregnancy Complications, Cardiovascular epidemiology, Puerperal Disorders epidemiology, Pulmonary Embolism epidemiology, Registries, Venous Thromboembolism epidemiology, Venous Thrombosis epidemiology
Abstract: Introduction: The aim of this study was to investigate the recurrence rate of venous thromboembolism (VTE) and the prevalence of major bleeding or death in patients with previous VTE in pregnancy and puerperium. Risk factors for VTE recurrence were also assessed., Materials and Methods: We evaluated a cohort of patients enrolled in the international, multicenter, prospective Registro Informatizado de la Enfermedad Trombo-Embólica (RIETE) registry with objectively confirmed VTE., Results: In the registry, 607 women were presenting with VTE that occurred during pregnancy or puerperium. The 2-year VTE recurrence rate was 3.3% (CI: 95 1.5-5.0%) and the recurrent VTE incidence rate was 2.28events/100 patients-year. Among the 16 cases of VTE recurrence 11 cases appeared during drug treatment while only five cases were diagnosed after therapy discontinuation. No significant difference was found in treatment duration among these two subgroups of VTE recurrence cases and women without recurrence. Furthermore, the use of thrombolytics and inferior vena cava filter in initial treatment was associated to an increased risk of VTE recurrence., Conclusions: The current study provides new insights on VTE recurrence rate in patients with deep vein thrombosis (DVT) or pulmonary embolism (PE) that occurred in pregnancy or postpartum period. These findings can contribute to risk assessment of thrombotic burden, thereby allowing for better decision making regarding antithrombotic management in this clinical setting., (Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)
Published: 2016
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22. Gender differences in cancer patients with acute venous thromboembolism.

Author: Martín-Martos F, Trujillo-Santos J, Barrón M, Vela J, Javier Marchena P, Braester A, Hij A, Hernández-Blasco L, Verhamme P, and Manuel M
Subjects: Acute Disease, Aged, Comorbidity, Female, Humans, Incidence, Male, Risk Factors, Sex Characteristics, Sex Distribution, Spain epidemiology, Survival Rate, Treatment Outcome, Anticoagulants therapeutic use, Hemorrhage mortality, Neoplasms mortality, Venous Thromboembolism drug therapy, Venous Thromboembolism mortality
Abstract: Background: The outcome of cancer patients with acute venous thromboembolism (VTE) may differ according to gender., Methods: We used the RIETE database to compare the rate of VTE (pulmonary embolism [PE] or deep vein thrombosis [DVT]) recurrences), major bleeding and mortality during the course of anticoagulation, according to gender., Results: As of August 2014, 11,055 patients with active cancer were enrolled in RIETE, of whom 5,104 (46%) were women. During the course of anticoagulation (mean: 142 days), 505 patients developed recurrent VTE, 429 bled and 2730 died. Compared with men, women had a significantly lower rate of fatal bleeding (risk ratio [RR]: 0.69; 95% CI: 0.47-0.99) and death (RR: 0.90; 95% CI: 0.83-0.97), and a non-significantly lower rate of PE recurrences (RR 0.83; 95% CI: 0.65-1.06) and major bleeding (RR: 0.89; 95% CI: 0.74-1.08)., Conclusions: During the course of anticoagulation, cancer women with VTE had a better outcome than men., (© 2015 Elsevier Ltd. All rights reserved.)
Published: 2015
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22 results on '"F Martín-Martos"'

1. Assessment of bleeding events in patients receiving DOACs with or without statins to treat venous thromboembolism: insights from the RIETE registry

2. First three months of anticoagulation for venous thromboembolism in non-cancer patients: LMWH VS. VKAs. Findings from the RIETE registry

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

4. Enoxaparin versus dalteparin or tinzaparin in patients with cancer and venous thromboembolism: The RIETECAT study

5. Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation

6. Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study

7. Timing and characteristics of venous thromboembolism after noncancer surgery

8. The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site

9. Gender differences in patients with venous thromboembolism and five common sites of cancer

10. Clinical outcomes during anticoagulant therapy in fragile patients with venous thromboembolism

11. Vitamin K Antagonists After 6 Months of Low-Molecular-Weight Heparin in Cancer Patients with Venous Thromboembolism

12. Analysis of noncatheter-associated upper extremity deep venous thrombosis from the RIETE registry

13. Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism

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

15. DVT Management and Outcome Trends, 2001 to 2014

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

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

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

19. A prognostic score to identify women at increased risk for abnormal uterine bleeding during anticoagulation for venous thromboembolism

20. Gender differences in patients with venous thromboembolism and five common sites of cancer.

21. Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism: Findings from the RIETE Registry.

22. Gender differences in cancer patients with acute venous thromboembolism.

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