Platelet Count and Major Bleeding in Patients Receiving Vitamin K Antagonists for Acute Venous Thromboembolism, Findings From Real World Clinical Practice.

Details

Serval ID
serval:BIB_4BCDB161AA2A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Platelet Count and Major Bleeding in Patients Receiving Vitamin K Antagonists for Acute Venous Thromboembolism, Findings From Real World Clinical Practice.
Journal
Medicine
Author(s)
Giorgi-Pierfranceschi M., Di Micco P., Cattabiani C., Guida A., Pagán B., Morales M.del V., Salgado E., Suriñach J.M., Tolosa C., Monreal M.
Working group(s)
RIETE Investigators
Contributor(s)
Adarraga M.D., Andújar V., Arcelus J.I., Ballaz A., Barba R., Barrón M., Blanco-Molina A., Casado I., Castejón-Pina N., de Miguel J., del Molino F., del Toro J., Diaz J.A., Falga C., Font L., Gallego P., Garcia- Bragado F., Gómez V., González J., Grau E., Guijarro R., Guirado L., ndez-Blasco L., Hernández- Huerta S., Jara-Palomares L., Jaras M.J., Jiménez D., Lacruz B., Lecumberri R., Lobo J.L., López-Reyes R., Sáez J.B., Lorente M.A., Lorenzo A., Madridano O., Maestre A., Marchena P.J., Martin-Martos F., Monreal M., Morales M.V., Nauffal D., Nieto J.A., Odriozola M., Otero R., Pagán B., Pedrajas J.M., Pérez G., Peris M.L., Pons I., Porras J.A., Riera-Mestre A., Rivas A., Rosa V., Sabio P., Sampériz A., Sánchez R., Sanz O., Soler S., Suriñach J.M., Tiberio G., Tolosa C., Trujillo-Santos J., Uresandi F., Valero B., Valle R., Vela J., Vela L., Vidal G., Vilar C., Villalobos A., Villalta J., Xifre B., Vanassche T., Verhamme P., Wells P., Hirmerova J., Maly R., Salgado E., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Hij A., Mahe I., Merah A., Moustafa F., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Apollonio A., Barillari G., Bucherini E., Ciammaichella M., Cola S., Di Micco P., Enea I., Ferrazzi P., Guida A., Lessiani G., Lodigiani C., Maida R., Mastroiacovo D., Pace F., Pasca S., Pesavento R., Pinelli M., Piovella C., Prandoni P., Rota L., Tiraferri E., Tonello D., Tufano A., Visona A., Zalunardo B., Belovs A., Sablinskis K., Skride A., Ribeiro F., Ribeiro J.L., Bosevski M., Zdraveska M., Alatri A., Bounameaux H., Calanca L., Mazzolai L.
ISSN
1536-5964 (Electronic)
ISSN-L
0025-7974
Publication state
Published
Issued date
11/2015
Peer-reviewed
Oui
Volume
94
Number
47
Pages
e1915
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The outcome of patients with acute venous thromboembolism (VTE) and abnormal platelet count (PlC) at baseline has not been consistently studied. In real-world clinical practice, a number of patients with abnormal PlC receive vitamin K antagonists (VKAs) to treat acute VTE despite their higher risk of bleeding.We used the Registro Informatizado de Enfermedad TromboEmbólica registry database to compare the rate of major bleeding in patients receiving VKA for long-term therapy of acute VTE according to PlC levels at baseline. Patients were categorized as having very low (<100,000/μL), low (100,000-150,000/μL), normal (150,000-300,000/μL), high (300,000-450,000/μL), or very high (>450,000/μL) PlC at baseline.Of 55,369 patients recruited as of January 2015, 37,000 (67%) received long-term therapy with VKA. Of these, 611 patients (1.6%) had very low PlC, 4006 (10.8%) had low PlC, 25,598 (69%) had normal PlC, 5801 (15.6%) had high PlC, and 984 (2.6%) had very high PlC at baseline. During the course of VKA therapy (mean, 192 days), there were no differences in the duration or intensity (as measured by international normalized ratio levels) of treatment between subgroups. The rate of major bleeding was 3.6%, 2.1%, 1.9%, 2.1%, and 3.7%, respectively, and the rate of fatal bleeding was 0.98%, 0.17%, 0.29%, 0.34%, and 0.50%, respectively. Patients with very low or very high PlC levels were more likely to have severe comorbidities.We found a nonlinear "U-shaped" relationship between PlC at baseline and major bleeding during therapy with VKA for VTE. Consistent alteration of PlC values at baseline suggested a greater frailty.
Keywords
Aged, Anticoagulants/adverse effects, Anticoagulants/therapeutic use, Female, Fibrinolytic Agents/adverse effects, Fibrinolytic Agents/therapeutic use, Follow-Up Studies, Hemorrhage/chemically induced, Hemorrhage/epidemiology, Humans, International Normalized Ratio, Male, Middle Aged, Platelet Count, Registries, Treatment Outcome, Venous Thromboembolism/drug therapy, Vitamin K
Pubmed
Web of science
Open Access
Yes
Create date
08/05/2020 13:36
Last modification date
02/06/2020 14:30
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