Incidence of major adverse cardiovascular events among patients with provoked and unprovoked venous thromboembolism: Findings from the Registro Informatizado de Enfermedad Tromboembólica Registry.

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Serval ID
serval:BIB_107FBD0E8813
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Incidence of major adverse cardiovascular events among patients with provoked and unprovoked venous thromboembolism: Findings from the Registro Informatizado de Enfermedad Tromboembólica Registry.
Journal
Journal of vascular surgery. Venous and lymphatic disorders
Author(s)
Golemi I., Cote L., Iftikhar O., Brenner B., Tafur A., Bikdeli B., Fernández-Capitán C., Pedrajas J.M., Otero R., Quintavalla R., Monreal M.
Working group(s)
Registro Informatizado de Enfermedad Tromboembólica Investigators
Contributor(s)
Monreal M., Prandoni P., Brenner B., Farge-Bancel D., Barba R., Di Micco P., Bertoletti L., Tzoran I., Reis A., Bounameaux H., Malý R., Verhamme P., Bosevski M., Caprini J.A., Bui H.M., Adarraga M.D., Aibar M.A., Aibar J., Amado C., Arcelus J.I., Azcarate P.M., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Camon A.M., Carrasco C., Castro J., de Ancos C., Del Toro J., Demelo P., Díaz-Pedroche M.C., Díaz-Peromingo J.A., Díaz-Simón R., Encabo M., Falgá C., Farfán A.I., Fernández-Capitán C., Fernández-Criado M.C., Fidalgo M.A., Font C., Font L., García M.A., García-Bragado F., García-Morillo M., García-Raso A., Gavín O., Gaya I., Gayol M.C., Gil-Díaz A., Guirado L., Gómez V., González-Martínez J., Grau E., Gutiérrez J., Hernández Blasco L.M., Iglesias M., Jara-Palomares L., Jaras M.J., Jiménez D., Jou I., Joya M.D., Lalueza A., Lima J., Llamas P., Lobo J.L., López-Jiménez L., López-Miguel P., López-Nuñez J.J., López-Reyes R., López-Sáez J.B., Lorente M.A., Lorenzo A., Loring M., Lumbierres M., Madridano O., Maestre A., Marchena P.J., Martín-Guerra J.M., Martín Fernández M., Mellado M., Monreal M., Morales M.V., Nieto J.A., Núñez M.J., Olivares M.C., Otalora S., Otero R., Pedrajas J.M., Pellejero G., Pérez-Pinar M., Pérez-Rus G., Peris M.L., Pesce M.L., Porras J.A., Rivas A., Rodríguez-Dávila M.A., Rodríguez-Fernández L., Rodríguez-Hernández A., Rodríguez-Martín C., Rubio C.M., Ruiz-Alcaraz S., Ruiz-Artacho P., Ruiz-Ruiz J., Ruiz-Sada P., Sahuquillo J.C., Salazar V., Sampériz A., Sánchez-Muñoz-Torrero J.F., Sancho T., Sanoja I., Soler S., Soto M.J., Suriñach J.M., Tolosa C., Torres M.I., Trujillo-Santos J., Uresandi F., Usandizaga E., Valle R., Vidal G., Gutiérrez P., Vázquez F.J., Vilaseca A., Vanassche T., Vandenbriele C., Verhamme P., Hirmerova J., Malý R., Salgado E., Benzidia I., Bertoletti L., Bura-Riviere A., Debourdeau P., Falvo N., Farge-Bancel D., Hij A., Mahé I., Moustafa F., Braester A., Brenner B., Ellis M., Tzoran I., Barillari G., Bilora F., Bortoluzzi C., Brandolin B., Bucherini E., Ciammaichella M., Dentali F., Di Micco P., Grandone E., Imbalzano E., Lessiani G., Maida R., Mastroiacovo D., Mumoli N., Vo Hong N., Pace F., Parisi R., Pesavento R., Pinelli M., Prandoni P., Quintavalla R., Rocci A., Siniscalchi C., Tufano A., Visonà A., Skride A., Sablinskis K., Sablinskis M., Bosevski M., Zdraveska M., Bounameaux H., Fresa M., Ney B., Mazzolai L., Caprini J., Tafur A., Bui H.M.
ISSN
2213-3348 (Electronic)
Publication state
Published
Issued date
05/2020
Peer-reviewed
Oui
Volume
8
Number
3
Pages
353-359.e1
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Overlap exists between the risk factors for coronary artery disease and venous thromboembolism (VTE). However, a paucity of data is available on the incidence of major acute cardiovascular events (MACE) and major adverse limb events (MALE) among patients presenting with VTE. Moreover, it is unknown whether the rate of cardiovascular outcomes differs among patients with unprovoked vs provoked VTE.
We analyzed the data from 2009 to 2017 in the Registro Informatizado de Enfermedad Tromboembólica registry, an ongoing, multicenter, international registry of consecutive patients with a diagnosis of objectively confirmed VTE. The query was restricted it to patients with data entry for the arterial outcomes. The baseline prevalence of coronary artery disease risk factors was compared between patients with provoked (ie, immobility, cancer, surgery, travel >6 hours, hormonal causes) and unprovoked VTE. After the initial VTE event, we followed up patients for the composite primary outcome of incident MACE (ie, stroke, myocardial infarction, unstable angina) and/or MALE (ie, major limb events). We used the χ <sup>2</sup> test for baseline associations and a Cox proportional hazard for multivariate analysis. We used IBM SPSS, version 24 (IBM Corp, Armonk, NY) for statistical analysis. A P value of <.05 was considered statistically significant.
We analyzed the data from 41,259 patients with VTE, of whom 22,633 (55.6%) had experienced a provoked VTE. During follow-up, the patients with provoked VTE were more likely to develop MACE or MALE than were patients with unprovoked VTE (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.1-1.5). The association of arterial events with recent immobility (HR, 1.4; 95% CI, 1.5-12.1) and cancer (HR, 1.7; 95% CI, 1.4-1.9) was strong. After adjusting for multiple conventional cardiovascular risk factors, provoked VTE, compared with unprovoked VTE, was significantly associated with an increased hazard for MACE (HR, 1.4; 95% CI, 1.1-1.7). Cancer remained a significant adjusted predictor for both MACE (HR, 1.7; 95% CI, 1.4-2.1) and MALE (HR, 2.1; 95% CI 1.01-4.6) in those with provoked VTE.
Among patients with VTE, provoked cases, specifically those with cancer-associated VTE, have an increased risk of major arterial events.
Keywords
Major adverse cardiovascular events, Major adverse limb events, Provoked, VTE, Venous thromboembolism
Pubmed
Web of science
Create date
26/11/2020 12:28
Last modification date
27/11/2020 6:26
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