D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry.
Details
Serval ID
serval:BIB_65527B6EFC5B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry.
Journal
Journal of internal medicine
Working group(s)
RIETE Investigators
Contributor(s)
Adarraga M.D., Aibar M.A., Aibar J., Amado C., Arcelus J.I., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Ina A., Camon A.M., Cañas I., Carrasco C., Castro J., de Ancos C., Del Toro J., Demelo P., Díaz-Peromingo J.A., Falgá C., Farfán A.I., Fernández-Capitán C., Fernández-Criado M.C., Fernández-Núñez S., Fidalgo M.A., Font C., Font L., Freire M., Gallego M., García M.A., García-Bragado F., García-Morillo M., García-Raso A., Gavín O., Gayol M.C., Gil-Díaz A., Gómez V., Gómez-Cuervo C., González-Martínez J., Grau E., Gutiérrez J., Hernández-Blasco L.M., Iglesias M., Jara-Palomares L., Jaras M.J., Jiménez R., Jiménez-Castro D., Jiménez-López J., Joya M.D., Lima J., Llamas P., Lobo J.L., López-Jiménez L., López-Miguel P., López-Núñez J.J., López-Reyes R., López-Sáez J.B., Lorente M.A., Lorenzo A., Loring M., Madridano O., Maestre A., Martín Del Pozo M., Martín-Guerra J.M., Martín-Romero M., Mellado M., Morales M.V., Muñoz N., Nieto-Cabrera M.A., Nieto-Rodríguez J.A., Núñez-Ares A., Núñez M.J., Olivares M.C., Otalora S., Otero R., Pedrajas J.M., Pellejero G., Pérez-Rus G., Peris M.L., Porras J.A., Rivas A., Rodríguez-Dávila M.A., Rodríguez-Hernández A., Rubio C.M., Ruiz-Artacho P., Ruiz-Ruiz J., Ruiz-Torregrosa P., Ruiz-Sada P., Sahuquillo J.C., Salazar V., Sampériz A., Sánchez-Muñoz-Torrero J.F., Sancho T., Soler S., Sopeña B., Suriñach J.M., Tolosa C., Torres M.I., Trujillo-Santos J., Uresandi F., Valle R., Vidal G., Villares P., Gutiérrez P., Vázquez F.J., Vilaseca A., Vanassche T., Vandenbriele C., Hirmerova J., Malý R., Salgado E., Benzidia I., Bertoletti L., Debourdeau P., Farge-Bancel D., Hij A., Moustafa F., Schellong S., Braester A., Brenner B., Tzoran I., Sharif-Kashani B., Bilora F., Bortoluzzi C., Bucherini E., Ciammaichella M., Dentali F., Di Micco P., Di Pangrazio M., Maida R., Mastroiacovo D., Pace F., Pallotti G., Parisi R., Pesavento R., Prandoni P., Quintavalla R., Rocci A., Siniscalchi C., Tufano A., Visonà A., Vo Hong N., Gibietis V., Skride A., Strautmane S., Bosevski M., Zdraveska M., Bounameaux H., Fresa M., Ney B., Caprini J., Bui H.M., Pham K.Q.
ISSN
1365-2796 (Electronic)
ISSN-L
0954-6820
Publication state
Published
Issued date
01/2020
Peer-reviewed
Oui
Volume
287
Number
1
Pages
32-41
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Patients with venous thromboembolism (VTE) secondary to transient risk factors may develop VTE recurrences after discontinuing anticoagulation. Identifying at-risk patients could help to guide the duration of therapy.
We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel).
In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d-dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19-9.57) events per 100 patient-years in those with raised d-dimer levels and 2.68 (95% CI: 1.45-4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71-10.4) and 3.34 (95% CI: 2.39-4.53), respectively. Patients with major risk factors and raised d-dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96-4.79) than those with normal levels. Patients with minor risk factors and raised d-dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51-3.63) than those with normal levels. On multivariate analysis, raised d-dimers (HR: 1.74; 95% CI: 1.09-2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors.
Patients with raised d-dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences.
We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel).
In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d-dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19-9.57) events per 100 patient-years in those with raised d-dimer levels and 2.68 (95% CI: 1.45-4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71-10.4) and 3.34 (95% CI: 2.39-4.53), respectively. Patients with major risk factors and raised d-dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96-4.79) than those with normal levels. Patients with minor risk factors and raised d-dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51-3.63) than those with normal levels. On multivariate analysis, raised d-dimers (HR: 1.74; 95% CI: 1.09-2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors.
Patients with raised d-dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences.
Keywords
Age Factors, Anticoagulants/therapeutic use, Female, Fibrin Fibrinogen Degradation Products/analysis, Humans, Male, Middle Aged, Prognosis, Recurrence, Registries, Risk Factors, Venous Thromboembolism/blood, Venous Thromboembolism/drug therapy, d-dimer, provoked venous thromboembolism, venous thromboembolism recurrence
Pubmed
Web of science
Create date
16/08/2019 21:59
Last modification date
29/08/2020 6:20
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