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3. Diagnostic management of acute pulmonary embolism: a prediction model based on a patient data meta-analysis

Author

van Es, Nick, primary, Takada, Toshihiko, additional, Kraaijpoel, Noémie, additional, Klok, Frederikus A, additional, Stals, Milou A M, additional, Büller, Harry R, additional, Courtney, D Mark, additional, Freund, Yonathan, additional, Galipienzo, Javier, additional, Le Gal, Grégoire, additional, Ghanima, Waleed, additional, Huisman, Menno V, additional, Kline, Jeffrey A, additional, Moons, Karel G M, additional, Parpia, Sameer, additional, Perrier, Arnaud, additional, Righini, Marc, additional, Robert-Ebadi, Helia, additional, Roy, Pierre-Marie, additional, Wells, Phil S, additional, de Wit, Kerstin, additional, van Smeden, Maarten, additional, and Geersing, Geert-Jan, additional

Published
2023
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6. Diagnostic management of acute pulmonary embolism: a prediction model based on a patient data meta-analysis

Author

HAG Trombose, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Epi Methoden Team 3, Infection & Immunity, Circulatory Health, van Es, Nick, Takada, Toshihiko, Kraaijpoel, Noémie, Klok, Frederikus A, Stals, Milou A M, Büller, Harry R, Courtney, D Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Grégoire, Ghanima, Waleed, Huisman, Menno V, Kline, Jeffrey A, Moons, Karel G M, Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre-Marie, Wells, Phil S, de Wit, Kerstin, van Smeden, Maarten, Geersing, Geert-Jan, HAG Trombose, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Epi Methoden Team 3, Infection & Immunity, Circulatory Health, van Es, Nick, Takada, Toshihiko, Kraaijpoel, Noémie, Klok, Frederikus A, Stals, Milou A M, Büller, Harry R, Courtney, D Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Grégoire, Ghanima, Waleed, Huisman, Menno V, Kline, Jeffrey A, Moons, Karel G M, Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre-Marie, Wells, Phil S, de Wit, Kerstin, van Smeden, Maarten, and Geersing, Geert-Jan

Published
2023

9. Diagnostic management of acute pulmonary embolism: a prediction model based on a patient data meta-analysis.

Author

Es, Nick van, Takada, Toshihiko, Kraaijpoel, Noémie, Klok, Frederikus A, Stals, Milou A M, Büller, Harry R, Courtney, D Mark, Freund, Yonathan, Galipienzo, Javier, Gal, Grégoire Le, Ghanima, Waleed, Huisman, Menno V, Kline, Jeffrey A, Moons, Karel G M, Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre-Marie, and Wells, Phil S

Subjects
PULMONARY embolism, CLINICAL prediction rules, NURSING home residents, PREDICTION models, VENOUS thrombosis, THROMBOEMBOLISM, SYMPTOMS
Abstract

Aims Risk stratification is used for decisions regarding need for imaging in patients with clinically suspected acute pulmonary embolism (PE). The aim was to develop a clinical prediction model that provides an individualized, accurate probability estimate for the presence of acute PE in patients with suspected disease based on readily available clinical items and D-dimer concentrations. Methods and results An individual patient data meta-analysis was performed based on sixteen cross-sectional or prospective studies with data from 28 305 adult patients with clinically suspected PE from various clinical settings, including primary care, emergency care, hospitalized and nursing home patients. A multilevel logistic regression model was built and validated including ten a priori defined objective candidate predictors to predict objectively confirmed PE at baseline or venous thromboembolism (VTE) during follow-up of 30 to 90 days. Multiple imputation was used for missing data. Backward elimination was performed with a P -value <0.10. Discrimination (c-statistic with 95% confidence intervals [CI] and prediction intervals [PI]) and calibration (outcome:expected [O:E] ratio and calibration plot) were evaluated based on internal-external cross-validation. The accuracy of the model was subsequently compared with algorithms based on the Wells score and D-dimer testing. The final model included age (in years), sex, previous VTE, recent surgery or immobilization, haemoptysis, cancer, clinical signs of deep vein thrombosis, inpatient status, D-dimer (in µg/L), and an interaction term between age and D-dimer. The pooled c-statistic was 0.87 (95% CI, 0.85–0.89; 95% PI, 0.77–0.93) and overall calibration was very good (pooled O:E ratio, 0.99; 95% CI, 0.87–1.14; 95% PI, 0.55–1.79). The model slightly overestimated VTE probability in the lower range of estimated probabilities. Discrimination of the current model in the validation data sets was better than that of the Wells score combined with a D-dimer threshold based on age (c-statistic 0.73; 95% CI, 0.70–0.75) or structured clinical pretest probability (c-statistic 0.79; 95% CI, 0.76–0.81). Conclusion The present model provides an absolute, individualized probability of PE presence in a broad population of patients with suspected PE, with very good discrimination and calibration. Its clinical utility needs to be evaluated in a prospective management or impact study. Registration PROSPERO ID 89366. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Safety and Efficiency of Diagnostic Strategies for Ruling Out Pulmonary Embolism in Clinically Relevant Patient Subgroups: A Systematic Review and Individual-Patient Data Meta-analysis

Author

HAG Trombose, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Epi Methoden Team 3, Infection & Immunity, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Stals, Milou A.M., Takada, Toshihiko, Kraaijpoel, Noémie, van Es, Nick, Büller, Harry R., Courtney, D. Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Grégoire, Ghanima, Waleed, Huisman, Menno V., Kline, Jeffrey A., Moons, Karel G.M., Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre Marie, van Smeden, Maarten, Wells, Phil S., de Wit, Kerstin, Geersing, Geert Jan, Klok, Frederikus A., HAG Trombose, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Epi Methoden Team 3, Infection & Immunity, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Stals, Milou A.M., Takada, Toshihiko, Kraaijpoel, Noémie, van Es, Nick, Büller, Harry R., Courtney, D. Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Grégoire, Ghanima, Waleed, Huisman, Menno V., Kline, Jeffrey A., Moons, Karel G.M., Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre Marie, van Smeden, Maarten, Wells, Phil S., de Wit, Kerstin, Geersing, Geert Jan, and Klok, Frederikus A.

Published
2022

12. Safety and Efficiency of Diagnostic Strategies for Ruling Out Pulmonary Embolism in Clinically Relevant Patient Subgroups

Author

Stals, Milou A.M., primary, Takada, Toshihiko, additional, Kraaijpoel, Noémie, additional, van Es, Nick, additional, Büller, Harry R., additional, Courtney, D. Mark, additional, Freund, Yonathan, additional, Galipienzo, Javier, additional, Le Gal, Grégoire, additional, Ghanima, Waleed, additional, Huisman, Menno V., additional, Kline, Jeffrey A., additional, Moons, Karel G.M., additional, Parpia, Sameer, additional, Perrier, Arnaud, additional, Righini, Marc, additional, Robert-Ebadi, Helia, additional, Roy, Pierre-Marie, additional, van Smeden, Maarten, additional, Wells, Phil S., additional, de Wit, Kerstin, additional, Geersing, Geert-Jan, additional, and Klok, Frederikus A., additional

Published
2022
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14. Uitsluiten van DVT met een klinische beslisregel

Author

Geersing, Geert-Jan, Zuithoff, Peter, Kearon, Clive, Anderson, David, ten Cate-Hoek, Arina, Elf, Johan, Bates, Shannon, Hoes, Arno, Kraaijenhagen, Roderick, Oudega, Ruud, Schutgens, Roger, Stevens, Scott, Woller, Scott, Wells, Phil, and Moons, Karel

Published
2014
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15. Diagnosing deep vein thrombosis in cancer patients with suspected symptoms: an individual participant data meta-analysis

Author

HAG Trombose, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Poli Van Creveldkliniek Medisch, Circulatory Health, Infection & Immunity, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Takada, Toshihiko, van Doorn, Sander, Parpia, Sameer, de Wit, Kerstin, Anderson, David R, Stevens, Scott M, Woller, Scott C, Ten Cate-Hoek, Arina J, Elf, Johan L, Kraaijenhagen, Roderik A, Schutgens, Roger E G, Wells, Phil S, Kearon, Clive, Moons, Karel G M, Geersing, Geert-Jan, HAG Trombose, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Poli Van Creveldkliniek Medisch, Circulatory Health, Infection & Immunity, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Takada, Toshihiko, van Doorn, Sander, Parpia, Sameer, de Wit, Kerstin, Anderson, David R, Stevens, Scott M, Woller, Scott C, Ten Cate-Hoek, Arina J, Elf, Johan L, Kraaijenhagen, Roderik A, Schutgens, Roger E G, Wells, Phil S, Kearon, Clive, Moons, Karel G M, and Geersing, Geert-Jan

Published
2020

17. Risk of Cardiovascular Events and Mortality Among Elderly Patients With Reduced GFR Receiving Direct Oral Anticoagulants

Author

Ashley, Justin, primary, McArthur, Eric, additional, Bota, Sarah, additional, Harel, Ziv, additional, Battistella, Marissa, additional, Molnar, Amber O., additional, Jun, Min, additional, Badve, Sunil V., additional, Garg, Amit X., additional, Manuel, Doug, additional, Tanuseputro, Peter, additional, Wells, Phil, additional, Mavrakanas, Thomas, additional, Rhodes, Emily, additional, and Sood, Manish M., additional

Published
2020
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20. Standardized Data Elements for Patients With Acute Pulmonary Embolism: A Consensus Report from the Pulmonary Embolism Research Collaborative

Author

Rosenfield, Kenneth, Bowers, Terry R., Barnett, Christopher F., Davis, George A., Giri, Jay, Horowitz, James M., Huisman, Menno V., Hunt, Beverley J., Keeling, Brent, Kline, Jeffrey A., Klok, Frederikus A., Konstantinides, Stavros V., Lanno, Michelle T., Lookstein, Robert, Moriarty, John M., Ní Áinle, Fionnuala, Reed, Jamie L., Rosovsky, Rachel P., Royce, Sara M., Secemsky, Eric A., Sharp, Andrew S. P., Sista, Akhilesh K., Smith, Roy E., Wells, Phil, Yang, Joanna, Whatley, Eleni M., Abudi, Tami, Adams, George, Ahmad, Hajira, Ajao, Adebola, Archard, Erin, Auger, William, Avila-Tang, Erika, Barnes, Geoff, Barnett, Christopher, Bashir, Riyaz, Benenati, James, Berman, Aaron, Bowers, Terry, Buck, Michael, Burnett, Allison, Cameron, Scott, Cavanaugh, Kenneth, Cerminaro, Michael, Daniel, Daniel, Daves, Seanna, Davis, George, Dicks, Andrew, Elder, Mahir, Farrell, Ann, Garman, Alissa, Gatzemeier, Jamee, Giannikopoulos, Demetri, Gibson, Michael, Goldberg, Joshua, Gonsalves, Carin, Grodzin, Charles, Gundert, Emily, Gurley, John, Heresi, Gustavo, Hlozek, Kristen, Hoerst, Stephen, Hooks, Brandon, Horowitz, James, Jaber, Wissam, Jaff, Michael, Jimenez, David, Johnston-Cox, Hillary, Kaatz, Scott, Kolluri, Raghu, Laird, John, Lake, Leslie, Langston, Matthew, Lossef, Steven, Love, Charles, Mackel, Julie, Massaro, Lori, McDaniel, Michael, McNally, Vicki, Merli, Geno, Mina, Bushra, Monreal, Manuel, Moores, Lisa, Morris, Timothy, Nossair, Fadi, O’Connell, Gregory, O’Corragain, Oisin, Ouriel, Kenneth, Parikh, Sahil, Piazza, Gregory, Pohlson, Katie, Polverini, Peter, Pomeroy, Jordan, Pugliese, Steve, Pullin, Brian, Quinto, Brian, Rali, Parth, Rivera-Lebron, Belinda, Robertson, Bill, Rosengard, Bruce, Shaw, Miranda, Simonton, Chuck, Sista, Akhilesh, Smith, Roy, Spyropoulos, Alex, Srivastava, Sanjay, Sterling, Keith, Strauss, Jayme, Taber, Margaret, Tapson, Victor, Tawney, Adam, Tu, Thomas, Valent, Tom, Venkat, Venkat, Walach, Elad, Ward, Rebecca, Ward, Adam, Weinberg, Ido, Wells, Phil, West, Frances Mae, West, Nick, Whatley, Eleni, Yang, Joanna, and Yongpravat, Charlie

Abstract

Recent advances in therapy and the promulgation of multidisciplinary pulmonary embolism teams show great promise to improve management and outcomes of acute pulmonary embolism (PE). However, the absence of randomized evidence and lack of consensus leads to tremendous variations in treatment and compromises the wide implementation of new innovations. Moreover, the changing landscape of health care, where quality, cost, and accountability are increasingly relevant, dictates that a broad spectrum of outcomes of care must be routinely monitored to fully capture the impact of modern PE treatment. We set out to standardize data collection in patients with PE undergoing evaluation and treatment, and thus establish the foundation for an expanding evidence base that will address gaps in evidence and inform future care for acute PE. To do so, >100 international PE thought leaders convened in Washington, DC, in April 2022 to form the Pulmonary Embolism Research Collaborative. Participants included physician experts, key members of the US Food and Drug Administration, patient representatives, and industry leaders. Recognizing the multidisciplinary nature of PE care, the Pulmonary Embolism Research Collaborative was created with representative experts from stakeholder medical subspecialties, including cardiology, pulmonology, vascular medicine, critical care, hematology, cardiac surgery, emergency medicine, hospital medicine, and pharmacology. A list of critical evidence gaps was composed with a matching comprehensive set of standardized data elements; these data points will provide a foundation for productive research, knowledge enhancement, and advancement of clinical care within the field of acute PE, and contribute to answering urgent unmet needs in PE management. Evidence produced through the Pulmonary Embolism Research Collaborative, as it is applied to data collection, promises to provide crucial knowledge that will ultimately produce a robust evidence base that will lead to standardization and harmonization of PE management and improved outcomes.

Published
2024
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21. Nurse clinic versus home delivery of evidence-based community leg ulcer care: A randomized health services trial

Author

Buchanan Maureen, VandenKerkhof Elizabeth, Lorimer Karen, Graham Ian D, Harrison Margaret B, Wells Phil S, Brandys Tim, and Pierscianowski Tadeusz

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background International studies report that nurse clinics improve healing rates for the leg ulcer population. However, these studies did not necessarily deliver similar standards of care based on evidence in the treatment venues (home and clinic). A rigorous evaluation of home versus clinic care is required to determine healing rates with equivalent care and establish the acceptability of clinic-delivered care. Methods Health Services RCT was conducted where mobile individuals were allocated to either home or nurse clinic for leg ulcer management. In both arms, care was delivered by specially trained nurses, following an evidence protocol. Primary outcome: 3-month healing rates. Secondary outcomes: durability of healing (recurrence), time free of ulcers, HRQL, satisfaction, resource use. Data were collected at base-line, every 3 months until healing occurred, with 1 year follow-up. Analysis was by intention to treat. Results 126 participants, 65 randomized to receive care in their homes, 61 to nurse-run clinics. No differences found between groups at baseline on socio-demographic, HRQL or clinical characteristics. mean age 69 years, 68% females, 84% English-speaking, half with previous episode of ulceration, 60% ulcers at inclusion < 5 cm2 for < 6 months. No differences in 3-month healing rates: clinic 58.3% compared to home care at 56.7% (p = 0.5) or in secondary outcomes. Conclusion Our findings indicate that organization of care not the setting where care is delivered influences healing rates. Key factors are a system that supports delivery of evidence-based recommendations with care being provided by a trained nursing team resulting in equivalent healing rates, HRQL whether care is delivered in the home or in a community nurse-led clinic. Trial registration ClinicalTrials.gov Protocol Registration System: NCT00656383

Published
2008
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22. Management of Severe Bleeding in Patients Treated with Direct Oral Anticoagulants

Author

Dennis, Jessica, Medina-Rivera, Alejandra, Truong, Vinh, Antounians, Lina, Zwingerman, Nora, Carrasco, Giovana, Strug, Lisa, Wells, Phil, Trégouët, France, Morange, France, Wilson, Michael, Gagnon, France, Albaladejo, Pierre, Samama, Marc, Sié, Pierre, Kauffmann, Sophie, Mémier, Vincent, Suchon, Pierre, Viallon, Alain, David, Stéphane, Gruel, Yves, Bellamy, Lorenn, de Maistre, Emmanuel, Romegoux, Pauline, Thoret, Sophie, Pernod, Gilles, Bosson, Jean-Luc, Bazin, Etienne, Combaret, Nicolas, Cherprenet, Anne, Fares, Moustafa, Dufraisse, Sophie, Minville, Vincent, Morange, Pierre-Emmanuel, Leone, Marc, Cohen, William, Néant, Nadège, Marlu, Raphaël, Carpentier, Françoise, Defaye, Pascal, Mismetti, Patrick, Molliex, Serge, Lanoiselée, Julien, Piriou, Vincent, Delaleu-Rague, Carine, Lefèvre, Mathilde, Lagrange, Sophie, Ardillon, Lauren, Ozier, Yves, Bovet, Julien, Steib, Annick, Mebaouj, Sonia, Profumo, Louis, Roullet, Stéphanie, Smadja, David, Meyer, Guy, Journois, Didier, Trinh-Duc, Albert, Viard, Thibault, Belle, Loic, Levrat, Albrice, Gautheron, Etienne, Heluwaert, Frédéric, Schlumberger, Sylvie, Blanié, Antonia, Benhamou, Dan, Flaujac, Claire, Rosencher, Nadia, Beloeil, Hélène, Blery, Catherine, Daviet, Lauren, Guéret, Pierre, Faraoni, David, Schved, Jean François, Deras, Pauline, Jaber, Samir, Gueugniaud, Pierre Yves, Floccard, Bernard, Asehnoune, Karim, Paulus, Jerome, Amrani, Omar, Gonthier, Marie Caroline, Huisse, Marie Geneviève, Josserand, Julien, de Raucourt, Emmanuelle, Defournel, Cécile, Dubois, Yohann, Bouvier, Stéphane, Roy, Pierre-Marie, Lasocki, Sigismond, Carmagnac, Christian, Chastagner, Catherine, Thouret, Jean Marc, Sevestre, Marie Antoinette, Meaudre, Eric, Cungi, Pierre-Julien, Susen, Sophie, Lefrant, Jean Yves, Macey, Stéphane, Rieu, Jean Baptiste, Godier, Anne, University of Toronto, Program in genetics and genome biology, The Hospital for sick children [Toronto] (SickKids), Department of Molecular Genetics, Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México = National Autonomous University of Mexico (UNAM), Division of Biostatistics, Dalla Lana School of Public Health, Ottawa Hospital Research Institute, ThEMAS, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Pôle Anesthésie Réanimation, CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon, Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Génétique, immunothérapie, chimie et cancer (GICC), UMR 7292 CNRS [2012-2017] (GICC UMR 7292 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Pôle Anesthésie Réanimation [CHU de Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Biotechnologies, Pharmacologie Moléculaire et Cellulaire, Institut de Recherches Servier, Service des urgences, CHU Grenoble, Cardiac Stimulation and Rhythmology, Groupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque (GRT), Université Jean Monnet - Saint-Étienne (UJM), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Cardiovasculaire, Hôpital Cardiologique de Lyon, Service de réanimation médicale polyvalente [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Anesthésie-Réanimation (TP - SAR), CHU Strasbourg, Espace Ethiques et Politiques - Institut Hannah Arendt (EEP), Université Paris-Est Marne-la-Vallée (UPEM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'Accueil des Urgences (AGEN - SAU), Centre Hospitalier d'Agen, Université de Bordeaux (UB), Service de Cardiologie (hôpital d'Annecy), Centre hospitalier de la région d'Annecy, Service d'hépato-gastroentérologie, Hôpital Cochin [AP-HP], Service d'anesthésie réanimation chirurgicale [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou, CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de réanimation chirurgicale, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Laboratoire SUBATECH Nantes (SUBATECH), Mines Nantes (Mines Nantes)-Université de Nantes (UN)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Service des Urgences (PMR), CHRU - ANGERS, CHU d'Angers [Département Urgences], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Pôle de Pathologie cardiologie-vasculaire, Institut d'Hématologie-Transfusion-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Unité de soins intensifs, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université Sorbonne Paris Cité (USPC), Universidad Nacional Autónoma de México (UNAM), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Pôle Anesthésie Réanimation, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Université de Tours-Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Institut de Chimie de la Matière Condensée de Bordeaux (ICMCB), Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB), Service d'Anesthésie-Réanimation, CHU Toulouse [Toulouse]-Institut Louis Bugnard-Hôpital de Rangueil, CHU Toulouse [Toulouse], INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Cochin [AP-HP], Service Anesthésie et Réanimation, Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Pôle Anesthésie Réanimation, Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université de Nantes (UN)-Mines Nantes (Mines Nantes), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse]-Institut Louis Bugnard, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Ingénierie et Santé (CIS-ENSMSE), and Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)

Subjects
Rivaroxaban, business.industry, [SDV]Life Sciences [q-bio], Renal function, 030204 cardiovascular system & hematology, 3. Good health, Dabigatran, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, Anesthesia, Medicine, Apixaban, Observational study, In patient, 030212 general & internal medicine, business, Prospective cohort study, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug, Cohort study
Abstract

Background The use of prothrombin complex concentrates and the role of plasma concentration of anticoagulants in the management of bleeding in patients treated with direct oral anticoagulants are still debated. Our aim was to describe management strategies and outcomes of severe bleeding events in patients treated with direct oral anticoagulants. Methods We performed a prospective cohort study of 732 patients treated with dabigatran, rivaroxaban, or apixaban hospitalized for severe bleeding, included prospectively in the registry from June 2013 to November 2015. Results Bleeding was gastrointestinal or intracranial in 37% (212 of 732) and 24% (141 of 732) of the cases, respectively. Creatinine clearance was lower than 60 ml/min in 61% (449 of 732) of the cases. The plasma concentration of direct oral anticoagulants was determined in 62% (452 of 732) of the cases and was lower than 50 ng/ml or higher than 400 ng/ml in 9.2% (41 of 452) and in 6.6% (30 of 452) of the cases, respectively. Activated or nonactivated prothrombin complex concentrates were administered in 38% of the cases (281 of 732). Mortality by day 30 was 14% (95% CI, 11 to 16). Conclusions Management of severe bleeding in patients treated with direct oral anticoagulants appears to be complex. The use of prothrombin complex concentrates differs depending on bleeding sites and direct oral anticoagulant plasma concentrations. Mortality differs according to bleeding sites and was similar to previous estimates.

Published
2017

23. Genetic variation 25.1 Mb upstream of tissue factor pathway inhibitor is associated with TFPI plasma levels and venous thromboembolism

Author

Dennis, Jessica, Truong, Vinh, Aïssi, Dylan, Medina-Rivera, Alejandra, Blankenberg, Stefan, Germain, Marine, Lemire, Mathieu, Antounians, Lina, Civelek, Mete, Schnabel, Renate, Wells, Phil, Wilson, Michael D., Morange, Pierre-Emmanuel, Trégouët, David-Alexandre, Gagnon, France, Dalla Lana School of Public Health, University of Toronto, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Universidad Nacional Autónoma de México (UNAM), Program in genetics and genome biology, The Hospital for sick children [Toronto] (SickKids), Department of General and Interventional Cardiology, University Heart Center Hamburg, Ontario Institute for Cancer Research [Canada] (OICR), Ontario Institute for Cancer Research, Department of Molecular Genetics [Toronto], University of Virginia [Charlottesville], Ottawa Hospital Research Institute [Ottawa] (OHRI), Nutrition, obésité et risque thrombotique (NORT), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL-UPMC, Gestionnaire, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Universidad Nacional Autónoma de México = National Autonomous University of Mexico (UNAM), University of Virginia, Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Canadian Institutes of Health Research [MOP 86466], Heart and Stroke Foundation of Canada [T6484], Heart and Stroke Foundation of Ontario [7486], Region Ile de France, Pierre and Marie Curie University, ICAN Institute for Cardiometabolism and Nutrition [ANR-10-IAHU-05], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Genetic Linkage, Thrombosis, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Blood Coagulation, Tissue Factor Pathway Inhibitor, Genetic Association Studies, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract

International audience; BackgroundTissue factor pathway inhibitor (TFPI) regulates fibrin clot formation, and low TFPI plasma levels increase the risk of arterial and venous thromboembolism (VTE). TFPI plasma levels are also heritable, and a previous linkage scan implicated the chromosome 2q region, but no specific genes.ObjectivesWe sought to replicate the linkage region in an independent sample and to identify the causal locus. MethodsWe first ran a linkage analysis of microsatellite markers and TFPI plasma levels in 251 individuals from the F5L Family Study and replicated the linkage peak on chromosome 2q (LOD=3.06). We next defined a follow-up region that included 112603 SNPs under the linkage peak, and meta-analyzed associations between these SNPs and TFPI plasma levels across the F5L Family Study and MARTHA, a study of 1033 unrelated VTE patients. SNPs with FDR q

Published
2016

25. Association between rivaroxaban use and length of hospital stay, treatment costs and early outcomes in patients with pulmonary embolism: a systematic review of real-world studies

Author

Kohn, Christine G., primary, Fermann, Gregory J., additional, Peacock, W. Frank, additional, Wells, Phil S., additional, Baugh, Christopher W., additional, Ashton, Veronica, additional, Crivera, Concetta, additional, Schein, Jeff R., additional, Wildgoose, Peter, additional, and Coleman, Craig I., additional

Published
2017
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26. Leveraging cell type specific regulatory regions to detect SNPs associated with tissue factor pathway inhibitor plasma levels

Author

Dennis, Jessica, primary, Medina-Rivera, Alejandra, additional, Truong, Vinh, additional, Antounians, Lina, additional, Zwingerman, Nora, additional, Carrasco, Giovana, additional, Strug, Lisa, additional, Wells, Phil, additional, Trégouët, David-Alexandre, additional, Morange, Pierre-Emmanuel, additional, Wilson, Michael D., additional, and Gagnon, France, additional

Published
2017
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29. Pulmonary embolism: Epidemiology and registries

Author

Monreal, Manuel, primary, Mahé, Isabelle, additional, Bura-Riviere, Alessandra, additional, Prandoni, Paolo, additional, Verhamme, Peter, additional, Brenner, Benjamin, additional, Wells, Phil S., additional, Di Micco, Pierpaolo, additional, and Bertoletti, Laurent, additional

Published
2015
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30. Homocysteine levels associate with subtle changes in leukocyte DNA methylation: an epigenome-wide analysis.

Author

Mandaviya, Pooja R, Aïssi, Dylan, Dekkers, Koen F, Joehanes, Roby, Kasela, Silva, Truong, Vinh, Stolk, Lisette, Heemst, Diana van, Ikram, M Arfan, Lindemans, Jan, Slagboom, P Eline, Trégouët, David-Alexandre, Uitterlinden, André G, Wei, Chen, Wells, Phil, Gagnon, France, van Greevenbroek, Marleen MJ, Heijmans, Bastiaan T, Milani, Lili, and Morange, Pierre-Emmanuel

Published
2017
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31. Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism

Author

Büller, Harry R, Décousus, Hervé, Grosso, Michael A, Mercuri, Michele, Middeldorp, Saskia, Prins, Martin H, Raskob, Gary E, Schellong, Sebastian M, Schwocho, Lee, Segers, Annelise, Shi, Minggao, Verhamme, Peter, Wells, Phil, Investigators, Hokusai-VTE, Jeppesen, Jørgen Lykke, Büller, Harry R, Décousus, Hervé, Grosso, Michael A, Mercuri, Michele, Middeldorp, Saskia, Prins, Martin H, Raskob, Gary E, Schellong, Sebastian M, Schwocho, Lee, Segers, Annelise, Shi, Minggao, Verhamme, Peter, Wells, Phil, Investigators, Hokusai-VTE, and Jeppesen, Jørgen Lykke

Published
2013

33. A Multicenter Randomized Placebo Controlled Trial of Compression Stockings to Prevent the Post-Thrombotic Syndrome After Proximal Deep Venous Thrombosis: The S.O.X. Trial

Author

Kahn, Susan R., primary, Shapiro, Stan, additional, Wells, Phil S, additional, Rodger, Marc A., additional, Kovacs, Michael J., additional, R, David Anderson, additional, Tagalakis, Vicky, additional, Johri, Mira, additional, Houweling, Adrielle H, additional, Holcroft, Christina, additional, Solymoss, Susan, additional, Miron, Marie-José, additional, Yeo, Erik, additional, Smith, Reginald, additional, Schulman, Sam, additional, Kassis, Jeannine, additional, Kearon, Clive, additional, Chagnon, Isabelle, additional, Wong, Turnly, additional, Demers, Christine, additional, Hanmiah, Rajendar, additional, Kaatz, Scott, additional, Selby, Rita, additional, Rathbun, Suman, additional, Desmarais, Sylvie, additional, Opatrny, Lucie, additional, Ortel, Thomas, additional, and Ginsberg, Jeffrey S., additional

Published
2012
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35. Postpartum Venous Thromboembolic Events Among Carriers of Factor V Leiden and/or Prothrombin Gene Variant: A Cohort Study and Updated Systematic Review. Is Prophylaxis Really Required?

Author

Lapner, Sarah Louise Dunbar Takach, primary, Le Gal, Gregoire, additional, Le Templier, Genevieve, additional, Walker, Mark, additional, Smith, Graeme N, additional, Wells, Phil, additional, Ramsay, Timothy, additional, Langlois, Nicole, additional, Carson, Nancy, additional, Wen, Shi Wu, additional, and Rodger, Marc A., additional

Published
2012
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36. Notes & Queries.

Author

Saunders, Walt, Winters, Dave, Hale, Ron, Wells, Phil, Thompson, Peter, Bartenstein, Fred, Steinberg, Jerry, and Snuggs, Bill

Abstract

Response for several letters in previous issue are presented including song "Hard Times" by Stephen Foster and a query of a reader concerning Tommy Wright & Len Wright and their song "Carolina Mountain Home" and answer of a question on singing lead of song "Tomorrow I 'll Be Gone."

Published
2016

41. Extended Follow-up of the Multi-Center Multi-National Prospective Cohort Study That Derived the “Men Continue and HERDOO2” Clinical Decision Rule Which Identifies Low Risk Patients Who May Be Able to Discontinue Oral Anticoagulants (Oac) 5-7 Months After Treatment for Unprovoked Venous Thromboembolism (VTE).

Author

Rodger, Marc, primary, Kovacs, Michael J., additional, Kahn, Susan, additional, Wells, Phil, additional, Anderson, David, additional, Gregoire, Le Gal, additional, Solymoss, Susan, additional, Chagnon, Isabelle, additional, Crowther, Mark A., additional, Perrier, Arnaud, additional, White, Richard H., additional, Betancourt, Marisol, additional, and Carrier, Marc, additional

Published
2009
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47. Use of Low Dose Oral Vitamin K in the Treatment of Patients with INR Values of More Than 10.0.

Author

Crowther, Mark A., primary, Garcia, David, primary, Ageno, Walter, primary, Witt, Daniel M., primary, Schulman, Sam, primary, Blostein, Mark, primary, Kovacs, Michael J., primary, Kearon, Clive, primary, Anderson, David, primary, Wells, Phil, primary, Ginsberg, Jeff S., primary, Selby, Rita, primary, Wang, Luqi, primary, and Kahn, Susan R., primary

Published
2005
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