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Duration of anticoagulation after isolated pulmonary embolism.
- Source :
-
The European respiratory journal [Eur Respir J] 2016 May; Vol. 47 (5), pp. 1429-35. Date of Electronic Publication: 2016 Feb 25. - Publication Year :
- 2016
-
Abstract
- In the D-dimer and ULtrasonography in Combination Italian Study (DULCIS), serial D-dimer measurement in combination with assessment of residual thrombosis (in patients with deep vein thrombosis (DVT)) identified patients who safely discontinued anticoagulation after an unprovoked venous thromboembolism (VTE).In this subgroup analysis, the value of D-dimer tests was assessed in patients with isolated pulmonary embolism (PE) compared with those with DVT, with or without PE (DVT/PE). The DULCIS database was reanalysed in relation to this target.26.8% of the DULCIS patients had isolated PE as the index event; this was more prevalent in females (34.1%) than in males (21.1%; p<0.0001). The rate of positive D-dimer was similar in isolated PE and DVT/PE. The rate of recurrences was not different in isolated PE or DVT/PE patients (4.8% ppy versus 3.8% ppy; nonsignificant) who stopped anticoagulation for negative D-dimer, but it was markedly high (11.2% ppy; p<0.0001) in those with isolated PE who remained without anticoagulation despite positive D-dimer. Recurrences were more frequently new isolated PE in patients with isolated PE than with DVT/PE (six (46.2%) out of 13 versus two (7.4%) out of 27; p=0.0085).Serial D-dimer assessment can inform on the risk of recurrent VTE and help determine the duration of anticoagulation in patients with isolated PE.<br /> (Copyright ©ERS 2016.)
- Subjects :
- Adult
Aged
Blood Coagulation
Body Mass Index
Female
Fibrin Fibrinogen Degradation Products analysis
Humans
Male
Middle Aged
Multivariate Analysis
Prevalence
Prospective Studies
Risk Factors
Sex Factors
Thrombolytic Therapy
Venous Thrombosis drug therapy
Anticoagulants administration & dosage
Pulmonary Embolism drug therapy
Venous Thromboembolism drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3003
- Volume :
- 47
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The European respiratory journal
- Publication Type :
- Academic Journal
- Accession number :
- 26917615
- Full Text :
- https://doi.org/10.1183/13993003.01126-2015