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Unprovoked VTE

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https://www.readbyqxmd.com/read/28321922/retrospective-evaluation-of-venous-thromboembolism-vte-are-all-transient-provoking-events-the-same
#1
Chong Chyn Chua, Hui Yin Lim, Mark Tacey, Harshal Nandurkar, Prahlad Ho
OBJECTIVES: Venous thromboembolism (VTE) provoked by transient risk factors has traditionally been classified as a single entity with lower risk of recurrence. We evaluated the association between different categories of transient provoking factors and the relative risk of recurrence. METHODS: Retrospective evaluation of VTE events in non-cancer patients from July 2011 to December 2012 at two tertiary institutions in Australia with a minimum follow up of 24 months...
March 21, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28321710/association-between-tlr9-rs5743836-polymorphism-and-risk-of-recurrent-venous-thromboembolism
#2
Abrar Ahmad, Kristina Sundquist, Bengt Zöller, Peter J Svensson, Jan Sundquist, Ashfaque A Memon
Recent gene knockout studies on mice have shown the role of toll-like receptor 9 (TLR9) in resolution of venous thromboembolism (VTE) through sterile inflammation. However, the role of a putative functional TLR9 polymorphism (rs5743836) in risk assessment of VTE recurrence remains unknown. The aim of our study was to investigate the TLR9 rs5743836 polymorphism in VTE patients and its association with the risk of VTE recurrence. We analyzed TLR9 rs5743836 polymorphism in Malmö thrombophilia study patients; a prospective follow-up study of 1465 VTE patients by Taqman PCR...
March 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28314711/validating-the-herdoo2-rule-to-guide-treatment-duration-for-women-with-unprovoked-venous-thrombosis-multinational-prospective-cohort-management-study
#3
Marc A Rodger, Gregoire Le Gal, David R Anderson, Jeannot Schmidt, Gilles Pernod, Susan R Kahn, Marc Righini, Patrick Mismetti, Clive Kearon, Guy Meyer, Antoine Elias, Tim Ramsay, Thomas L Ortel, Menno V Huisman, Michael J Kovacs
Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants...
March 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28262729/abo-blood-types-associated-with-the-risk-of-venous-thromboembolism-in-han-chinese-people-a-hospital-based-study-of-200-000-patients
#4
Xuefeng Sun, Jun Feng, Wei Wu, Min Peng, Juhong Shi
ABO blood types are putatively associated with the risk of venous thromboembolism (VTE), but it is not proved in Chinese people. A large population of Han Chinese patients discharged from Peking Union Medical College Hospital between January 2010 and June 2016 were retrospectively analyzed in a case-control study. A total of 1412 VTE patients were identified from 200,660 discharged Han Chinese patients, including 600 patients with deep vein thrombosis (DVT), 441 patients with pulmonary embolism, and 371 patients with both DVT and pulmonary embolism...
March 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28262237/outcome-after-discontinuing-anticoagulant-therapy-in-women-with-venous-thromboembolism-during-hormonal-use
#5
Ángeles Blanco-Molina, Javier Trujillo-Santos, Raffaele Pesavento, Vladimir Rosa, Conxita Falgá, Carles Tolosa, Lucia Mazzolai, Ángel Sampériz, Rita Duce, Manuel Monreal
INTRODUCTION: Whether women developing venous thromboembolism (VTE) while using hormonal therapy should be classified as having "unprovoked" or "provoked" VTE is controversial. METHODS: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic VTE recurrences after discontinuing anticoagulation in 3 subgroups of women aged ≤50years without cancer, pregnancy or puerperium: (1) those with hormonal therapy and no additional risk factors (hormonal users only); (2) those with unprovoked VTE; and (3) those with additional risk factors, with or without hormonal therapy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28237891/bleeding-risk-in-patients-with-unprovoked-venous-thromboembolism-a-critical-appraisal-of-clinical-prediction-scores
#6
REVIEW
Nick van Es, Philip S Wells, Marc Carrier
Patients with unprovoked venous thromboembolism (VTE) should receive anticoagulant treatment for at least 3 to 6months. Thereafter, the decision to extend treatment indefinitely for secondary prevention of recurrent events is based on a personalized assessment of the risks of recurrent VTE and anticoagulant-related bleeding. Whereas there are clinical factors that identify patients at higher risk of recurrent VTE, factors to aid the prediction of major bleeding events during anticoagulant therapy have received much less attention...
February 20, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28211051/antibiotic-use-associated-with-vte-and-its-implications-a-new-trigger-for-thromboprophylaxis-and-for-reclassification-of-some-unprovoked-to-provoked-vte-s
#7
EDITORIAL
Jürg H Beer
No abstract text is available yet for this article.
March 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28208203/acute-pulmonary-embolism-after-discharge-duration-of-therapy-and-follow-up-testing
#8
Cecilia Becattini, Laura Franco, Giancarlo Agnelli
Pulmonary embolism (PE) is a frequent cause of death and serious disability with a risk extending far beyond the acute phase of the disease. Anticoagulant treatment reduces the risk for death and recurrent VTE after a first PE. The optimal duration of anticoagulation after a first episode of PE remains controversial and should be made on an individual basis, balancing the estimated risk for recurrence without anticoagulant treatment against bleeding risk under anticoagulation. Current recommendations on duration of anticoagulation are based on a 3% per year risk of major bleeding expected during long-term warfarin treatment...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28166605/d-dimer-at-venous-thrombosis-diagnosis-is-associated-with-risk-of-recurrence
#9
E Bjøri, H S Johnsen, J-B Hansen, S K Braekkan
Essentials Whether D-dimer at incident venous thromboembolism (VTE) can predict recurrence-risk is unknown. We explored this association in 454 cancer-free patients with a first lifetime VTE. A low D-dimer at first VTE diagnosis was associated with a low recurrence risk. The association was predominant in patients with deep vein thrombosis and unprovoked VTE. Click to hear Dr Cannegieter's presentation on venous thrombosis: prediction of recurrence SUMMARY: Background Venous thromboembolism (VTE) is a common disease with a high recurrence rate...
February 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28160670/cost-effectiveness-of-the-addition-of-a-comprehensive-ct-scan-to-the-abdomen-and-pelvis-for-the-detection-of-cancer-after-unprovoked-venous-thromboembolism
#10
Kathryn Coyle, Marc Carrier, Alejandro Lazo-Langner, Sudeep Shivakumar, Ryan Zarychanski, Vicky Tagalakis, Susan Solymoss, Nathalie Routhier, James Douketis, Douglas Coyle
IMPORTANCE: Unprovoked venous thromboembolism (VTE) can be the first manifestation of cancer. It is unclear if extensive screening for occult cancer including a comprehensive computed tomography (CT) scan of the abdomen/pelvis is cost-effective in this patient population. OBJECTIVE: To assess the health care related costs, number of missed cancer cases and health related utility values of a limited screening strategy with and without the addition of a comprehensive CT scan of the abdomen/pelvis and to identify to what extent testing should be done in these circumstances to allow early detection of occult cancers...
January 25, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28150371/venous-thromboembolism-management-practices-and-knowledge-of-guidelines-a-survey-of-australian-haematologists-and-respiratory-physicians
#11
Rory Wallace, Mary-Ann Anderson, Katharine See, Ms Alexandra Gorelik, A/Prof Louis Irving, Renee Manser
BACKGROUND: Current international clinical practice guidelines do not adequately address all clinical scenarios in the management of venous thromboembolism (VTE) and no comprehensive Australian guidelines exist. We aimed to identify areas of uncertainty in VTE management and whether self-reported practice is consistent with guidelines. METHODS: We conducted an Australian cross-sectional online survey consisting of 53 questions to investigate doctors' VTE management practices...
February 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28149566/utility-of-thrombophilia-testing-in-patients-with-venous-thrombo-embolism
#12
Masataka Kudo, Huang L Lee, Ian A Yang, Philip J Masel
BACKGROUND: Clinical practice of thrombophilia testing those with venous thrombo-embolism (VTE) in public hospitals may not be consistent with the international guidelines. This study aims to assess whether practice of thrombophilia testing in two public hospitals are consistent with international guidelines, and to assess whether certain groups of patients were more likely to benefit from testing. METHODS: A retrospective audit on patients who presented to two Queensland public hospitals from August 2011 to September 2012 with VTE...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28126238/measures-of-kidney-disease-and-the-risk-of-venous-thromboembolism-in-the-regards-reasons-for-geographic-and-racial-differences-in-stroke-study
#13
Katharine L Cheung, Neil A Zakai, Aaron R Folsom, Manjula Kurella Tamura, Carmen A Peralta, Suzanne E Judd, Peter W Callas, Mary Cushman
BACKGROUND: Kidney disease has been associated with venous thromboembolism (VTE) risk, but results conflict and there is little information regarding blacks. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 30,239 black and white adults 45 years or older enrolled in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study 2003 to 2007. PREDICTORS: Estimated glomerular filtration rate (eGFR) using the combined creatinine-cystatin C (eGFRcr-cys) equation and urinary albumin-creatinine ratio (ACR)...
January 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28106922/recurrence-risk-of-venous-thromboembolism-and-hormone-use-in-women-from-england-a-cohort-study-using-clinical-practice-research-datalink
#14
Sylvia Kiconco, Alyshah Abdul Sultan, Matthew J Grainge
It is vital to identify people with low recurrence risk of venous thromboembolism (VTE) so as to protect them from dangers of prolonged anticoagulation therapy. Among women who develop VTE following hormone use, the evidence as to whether their risk of recurrence is low if they cease this therapy is conflicting. We investigated whether women whose initial VTE event was hormone-related have a lower risk of VTE recurrence than women whose initial event had no obvious cause (unprovoked). A cohort study utilising the Clinical Practice Research Datalink linked to Hospital Episode Statistics data from England was conducted...
January 20, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28102773/the-optimal-duration-of-anticoagulant-therapy-after-unprovoked-venous-thromboembolism-still-a-challenging-issue
#15
Giovanna Elmi, Giuseppe Di Pasquale, Raffaele Pesavento
As about 50 % of patients with unprovoked venous thromboembolism (VTE) will develop new episodes after discontinuing therapy, indefinite treatment is suggested in patients with low or moderate bleeding risk. Baseline and post-baseline factors can help clinicians to identify patients at high risk of recurrence, who require extended treatment. Residual vein obstruction and D-dimer assay have been shown to be suitable methods for assessing the risk of VTE recurrences after a first unprovoked VTE. In treatment for VTE the use of direct oral anticoagulants (DOAC) is growing instead of the standard adjusted dose of vitamin K antagonists...
January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28049360/identification-of-genetic-aberrations-in-thrombomodulin-gene-in-patients-with-recurrent-venous-thromboembolism
#16
Abrar Ahmad, Kristina Sundquist, Bengt Zöller, Peter J Svensson, Jan Sundquist, Ashfaque A Memon
Thrombomodulin (THBD) serves as a cofactor for thrombin-mediated activation of anticoagulant protein C pathway. Genetic aberrations in THBD have been studied in arterial and venous thrombosis. However, genetic changes in THBD and their role in the risk assessment of recurrent venous thromboembolism (VTE) are not well understood. The aim of the present study was to identify the genetic aberrations in THBD and their association with the risk of VTE recurrence in a prospective population-based study. We sequenced the entire THBD gene, first in selected patients with VTE (n = 95) by Sanger sequencing and later validated those polymorphisms with minor allele frequency (MAF) ≥5% in the whole study population (n = 1465 with the follow-up period of 1998-2008) by Taqman polymerase chain reaction...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28010922/risk-factors-for-symptomatic-venous-and-arterial-thromboembolism-in-newborns-children-and-adolescents-what-did-we-learn-within-the-last-20years
#17
Gili Kenet, Verena Limperger, Maria Shneyder, Ulrike Nowak-Göttl
Venous thrombosis (VTE) in children is increasingly diagnosed, as advanced medical care has increased treatment intensity of hospitalized pediatric patients. The aim of this review was to summarize the data available and to discuss the controversial issue of thrombophilia screening in the light of the pediatric data available. Follow-up data for VTE recurrence in children suggest a recurrence rate between 3% (neonates) and 21% in individuals with unprovoked VTE. Apart from underlying medical conditions, recently reported systematic reviews on pediatric VTE (70% provoked) have shown significant associations between thrombosis and presence of protein C-, protein S- and antithrombin deficiency, factor 5 (F5: rs6025), factor 2 (F2: rs1799963), even more pronounced when combined inherited thrombophilias [IT] were involved...
December 14, 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/27982558/optimal-duration-of-anticoagulation-in-patients-with-unprovoked-venous-thromboembolism-the-impact-of-the-novel-anticoagulants
#18
Paolo Prandoni, Marta Milan, Lucia Sarolo, Ezio Zanon, Franca Bilora
Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years approaches 50% of all patients with a first episode of unprovoked VTE. The persistence of residual vein thrombosis at ultrasound assessment has consistently been shown to increase the risk, as do persistently high values of D-Dimer. Although the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, strategies that incorporate the assessment of residual vein thrombosis and D-dimer have the potential to identify a substantial proportion of subjects in whom anticoagulation can be safely discontinued...
December 16, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27931012/impact-of-thrombophilia-screening-on-venous-thromboembolism-management-practices
#19
Alejandro Garcia-Horton, Michael J Kovacs, Jameel Abdulrehman, Jay E Taylor, Shobha Sharma, Alejandro Lazo-Langner
BACKGROUND: It is unclear whether thrombophilia testing provides any further information on risk of recurrence or guidance in management of patients with a first episode of idiopathic venous thromboembolism (VTE). Furthermore, after the introduction to clinical practice of clinical prediction rules, thrombophilia screening could be less relevant in anticoagulation decision making. We assessed the potential impact of thrombophilia screening on the decision of maintaining anticoagulation beyond the initially planned anticoagulation period in patients with an unprovoked VTE, before and after the introduction of a clinical prediction rule into practice...
January 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27886530/choosing-wisely-the-impact-of-patient-selection-on-efficacy-and-safety-outcomes-in-the-einstein-dvt-pe-and-amplify-trials
#20
Jan Beyer-Westendorf, Anthonie W A Lensing, Roopen Arya, Henri Bounameaux, Alexander T Cohen, Philip S Wells, Saskia Middeldorp, Peter Verhamme, Rodney Hughes, Nils Kucher, Akos F Pap, Mila Trajanovic, Martin H Prins, Paolo Prandoni, Jeffrey I Weitz
BACKGROUND: The results of the EINSTEIN-DVT/PE and AMPLIFY trials, which compared rivaroxaban and apixaban with conventional anticoagulation therapy for acute venous thromboembolism (VTE), respectively, are often compared. However, the trials differed in duration of therapy (3-12 and 6months, respectively) and in patient selection (few exclusion criteria and more stringent exclusion criteria, respectively). METHODS: To determine the effect of these methodological differences on outcomes, the patients enrolled in EINSTEIN-DVT/PE were divided into 2 cohorts; the 5253 patients that matched the exclusion criteria for AMPLIFY and were treated for at least 6months (cohort 1) and the 2368 patients who would have been ineligible for AMPLIFY (cohort 2)...
January 2017: Thrombosis Research
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