Duration of anticoagulation after venous thromboembolism in real world clinical practice.
Details
Serval ID
serval:BIB_B3F62364D1D2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Duration of anticoagulation after venous thromboembolism in real world clinical practice.
Journal
Thrombosis Research
Working group(s)
RIETE investigators
Contributor(s)
Ameneiro E., Andújar V., Arcelus JI., Arroyo-Cozar M., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Bueso T., Casado I., Conget F., del Molino F., del Toro J., Falgá C., Fernández-Capitán C., Font L., Fuentes MI., Gallego P., García-Bragado F., García-Lorenzo MD., Gómez V., González J., González-Bachs E., Guil M., Gutiérrez J., Hernández L., Hernández-Huerta D., Jaras MJ., Jiménez D., Lecumberri R., Lobo JL., López-Jiménez L., López-Montes L., López-Reyes R., López-Sáez JB., Lorente MA., Lorenzo A., Luque JM., Madridano O., Marchena PJ., Martín M., Mellado M., Monreal M., Nauffal D., Nieto JA., Núñez MJ., Ogea JL., Pedrajas JM., Pérez G., Peris ML., Porras JA., Riera-Mestre A., Rivas A., Rodríguez-Dávila MA., Román P., Roncero A., Rosa V., Ruiz-Giménez N., Ruiz J., Sahuquillo JC., Samperiz A., Sánchez R., Sánchez Muñoz-Torrero JF. , Soler S., Suriñach JM., Tiberio G., Tilván RM., Tolosa C., Trujillo-Santos J., Uresandi F., Valdés M., Valero B., Valle R., Vela J., Vidal G., Vilar C., Villalta J., Verhamme P., Peerlinck K., Wells P., Malý R., Hirmerova J., Kaletova M., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Hij A., Mahe I., Merah A., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Zeltser D., Amitrano M., Apollonio A., Barillari G., Ciammaichella M., Dentali F., Di Micco P., Duce R., Guida A., Maida R., Pasca S., Pesavento R., Piovella C., Prandoni P., Rota L., Tiraferri E., Tonello D., Tufano A., Visonà A., Zalunardo B., Barbosa AL., Bastos M., Sousa MS., Bosevski M., Duskoski D., Kovacevic D., Alatri A., Bounameaux H., Calanca L., Mazzolai L.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
135
Number
4
Pages
666-672
Language
english
Notes
Alatri A. fait parti du RIETE group
Abstract
INTRODUCTION: Venous thromboembolism (VTE) carries a considerable risk of recurrence and anticoagulants should be administered for a minimum of three months. Since little is known about real life management of VTE, we aimed to describe current practice in the secondary prevention of VTE.
MATERIALS AND METHODS: Using the database of an international, prospective registry on patients treated for VTE, RIETE, information was collected on risk factors for VTE and bleeding, anticoagulant treatment, and clinical outcomes during follow up. Multivariate analysis using logistic regression was performed to identify predictors of treatment duration.
RESULTS: Of 6944 patients with a first episode of VTE 41.1% had unprovoked VTE, 31.8% had transient risk factors, 27.1% had cancer. After the exclusion of patients who died during the first year of observation, the rate of patients treated for >12 months was 55.1%, 41.9%, and 43.2%, respectively (p<0.001). Pulmonary embolism at presentation, recurrence while on treatment, chronic heart failure and age >65 years were independently associated with treatment for >12 months. Body weight <75 kg, anemia, cancer, and the presence of transient risk factors were associated with treatment for 12 months or less. Major bleeding occurred more frequently than recurrent VTE in patients with VTE secondary to transient risk factors and cancer; fatal bleeding was more frequent than fatal recurrent PE in all subgroups.
CONCLUSIONS: We observed heterogeneous duration of anticoagulant treatment for the secondary prevention of VTE. A substantial proportion of patients, in particular those with VTE secondary to transient risk factors, may be exposed to a possibly unnecessary risk of bleeding.
MATERIALS AND METHODS: Using the database of an international, prospective registry on patients treated for VTE, RIETE, information was collected on risk factors for VTE and bleeding, anticoagulant treatment, and clinical outcomes during follow up. Multivariate analysis using logistic regression was performed to identify predictors of treatment duration.
RESULTS: Of 6944 patients with a first episode of VTE 41.1% had unprovoked VTE, 31.8% had transient risk factors, 27.1% had cancer. After the exclusion of patients who died during the first year of observation, the rate of patients treated for >12 months was 55.1%, 41.9%, and 43.2%, respectively (p<0.001). Pulmonary embolism at presentation, recurrence while on treatment, chronic heart failure and age >65 years were independently associated with treatment for >12 months. Body weight <75 kg, anemia, cancer, and the presence of transient risk factors were associated with treatment for 12 months or less. Major bleeding occurred more frequently than recurrent VTE in patients with VTE secondary to transient risk factors and cancer; fatal bleeding was more frequent than fatal recurrent PE in all subgroups.
CONCLUSIONS: We observed heterogeneous duration of anticoagulant treatment for the secondary prevention of VTE. A substantial proportion of patients, in particular those with VTE secondary to transient risk factors, may be exposed to a possibly unnecessary risk of bleeding.
Keywords
Aged, Anticoagulants/administration & dosage, Anticoagulants/therapeutic use, Female, Humans, Male, Risk Factors, Venous Thromboembolism/drug therapy, Venous Thromboembolism/pathology
Pubmed
Web of science
Create date
12/02/2016 14:56
Last modification date
28/05/2020 6:26
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