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Unprovoked VTE

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/27876590/clinical-prognosis-of-non-massive-central-and-non-central-pulmonary-embolism-a-registry-based-cohort-study
#8
Bobby Gouin, Marc Blondon, David Jiménez, Carmen Fernández-Capitán, Henri Bounameaux, Silvia Soler, Rita Duce, Joan Carles Sahuquillo, Nuria Ruiz-Giménez, Manuel Monreal
BACKGROUND: Whether the localization of non-massive pulmonary embolism (PE) is associated with the short and long-term prognosis of patients remains unknown. Our aim is to characterize associations of non-massive PE localization with risks of recurrent venous thromboembolism (VTE), major bleeding and mortality during and after anticoagulation. METHODS: Among participants of the RIETE registry with an incident symptomatic non-massive PE diagnosed by computerized tomography (CT), we compared risks of recurrent VTE, major bleeding and mortality during and after anticoagulation period between central PE (main pulmonary artery) and non-central PE (more peripheral arteries), using Cox proportional hazard adjusted models...
November 19, 2016: Chest
https://www.readbyqxmd.com/read/27831499/association-of-traditional-cardiovascular-risk-factors-with-venous-thromboembolism-an-individual-participant-data-meta-analysis-of-prospective-studies
#9
Bakhtawar K Mahmoodi, Mary Cushman, Inger Anne Næss, Matthew A Allison, Willem Jan Bos, Sigrid K Brækkan, Suzanne C Cannegieter, Ron T Gansevoort, Philimon N Gona, Jens Hammerstrøm, John-Bjarne Hansen, Susan Heckbert, Anders G Holst, Susan G Lakoski, Pamela L Lutsey, JoAnn E Manson, Lisa W Martin, Kunihiro Matsushita, Karina Meijer, Kim Overvad, Eva Prescott, Marja Puurunen, Jacques E Rossouw, Yingying Sang, Marianne T Severinsen, Jur Ten Berg, Aaron R Folsom, Neil A Zakai
BACKGROUND: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). METHODS: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines...
January 3, 2017: Circulation
https://www.readbyqxmd.com/read/27821402/ischemic-stroke-and-risk-of-venous-thromboembolism-in-the-general-population-the-troms%C3%A3-study
#10
Ludvig B Rinde, Birgit Småbrekke, Ellisiv B Mathiesen, Maja-Lisa Løchen, Inger Njølstad, Erin M Hald, Tom Wilsgaard, Sigrid K Brækkan, John-Bjarne Hansen
BACKGROUND: Even though clinical data support a relation between ischemic stroke and venous thromboembolism (VTE), the strength and time dependence of the association remain to be settled at the population level. We therefore aimed to investigate the association between ischemic stroke and VTE in a prospective population-based cohort. METHODS AND RESULTS: Participants (n=30 002) were recruited from 3 surveys of the Tromsø study (conducted in 1994-1995, 2001, and 2007-2008) and followed through 2010...
November 7, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27815969/residual-pulmonary-vascular-obstruction-and-recurrence-after-acute-pulmonary-embolism-a-single-center-cohort-study
#11
Benjamin Planquette, Alexis Ferré, Julien Peron, Amandine Vial-Dupuy, Jean Pastre, Gisèle Mourin, Joseph Emmerich, Marie-Anne Collignon, Guy Meyer, Olivier Sanchez
INTRODUCTION: Up to 50% of patients with pulmonary embolism (PE) present lung perfusion defects after six months of anticoagulant treatment, suggesting residual pulmonary vascular obstruction (RPVO). The risk of recurrence in patients with RPVO remains unknown. The present study aims to assess the risk of recurrent venous thromboembolism (VTE) in patients with RPVO after a first symptomatic episode of PE. METHODS: Consecutive patients who survived a first objectively proven acute PE, treated for at least three months with anticoagulants, were included and followed prospectively...
December 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27812260/red-cell-distribution-width-has-a-predictable-value-for-differentiation-of-provoked-and-unprovoked-venous-thromboembolism
#12
Sehmus Ertop, Muammer Bilici, Huseyin Engin, Cagatay Buyukuysal, Muzeyyen Arslaner, Bilal Toka, Ishak Ozel Tekin
Venous thromboembolism (VTE) is generally classified as provoked or unprovoked. This dichotomy is important for following patients, mortality rate, prognosis and whether more efficient therapy is needed. In VTE patients, during initial diagnosis, it is not known exactly whether red cell distribution width (RDW) have a predictable value for this differentiation and pathogenesis. In this study, 298 patients with VTE and 197 control subjects were included. Patients with VTE were defined as provoked or unprovoked with respect to physical examination findings and laboratory values...
December 2016: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/27771600/deep-venous-thrombosis-as-the-single-sign-of-unexpected-metastatic-urinary-tract-cancer-in-a-patient-with-a-history-of-cutaneous-melanoma-a-case-report
#13
Joachim Mikkelsen, Steen Henrik Matzen
INTRODUCTION: Cancer is a recognized risk factor of venous thromboembolism (VTE) as it induces a prothrombotic state through various mechanisms of activation of coagulation. Recognizing occult cancer as a risk factor is equally important. In patients with no known thromboembolic risk factors, utilizing PET/CT as a screening tool may be considered in order to reveal occult malignancy associated with otherwise unexplainable VTE. METHODS: This case report has been reported in line with the SCARE criteria...
October 14, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27766390/jak2v617f-and-calreticulin-mutations-in-recurrent-venous-thromboembolism-results-from-the-edith-prospective-cohort
#14
Jean-Christophe Ianotto, Aurélie Chauveau, Dominique Mottier, Valérie Ugo, Christian Berthou, Eric Lippert, Aurélien Delluc
Cancer incidence in patients with recurrent unprovoked venous thromboembolism (VTE) is much higher than after a first event, but the incidence of myeloproliferative neoplasms (MPN) in this situation is still unknown. We tested for JAK2V617F and calreticulin mutants, 372 DNA samples of patients treated for (VTR). Among these patients, 10 (2.7%) were carrying JAK2V617F mutation and none of them any of the calreticulin (CALR) mutations. Among the 19 patients who had VTE recurrence under vitamin K antagonists, 4 patients (21...
October 20, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27766052/cancer-associated-thrombosis-in-asia
#15
Pantep Angchaisuksiri
Thrombosis is a common complication in cancer patients. Although the major inherited risk factors for thrombophilia are different between Asians and Caucasians, the main acquired risk factors that are associated with the development of venous thromboembolism (VTE) in Asians appear to be similar to those for Caucasians. Malignancy is the most important acquired risk factor for VTE in Asians. Recent studies have shown that the incidence of VTE is significant in Asian patients with cancer, particularly those in an advanced stage...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27764967/cardiovascular-fitness-in-young-males-and-risk-of-unprovoked-venous-thromboembolism-in-adulthood
#16
Bengt Zöller, Henrik Ohlsson, Jan Sundquist, Kristina Sundquist
BACKGROUND: Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. The present study aims to determine whether high cardiovascular fitness reduces the risk of VTE. METHODS: A Swedish cohort of male conscripts (n = 773,925) born in 1954-1970 with no history of previous VTE were followed from enlistment (1972-1990) until 2010. Data on cardiovascular fitness using a cycle ergonometric test (maximal aerobic workload in Watt [Wmax]) at conscription were linked with national hospital register data and the Multi-Generation Register...
March 2017: Annals of Medicine
https://www.readbyqxmd.com/read/27764883/epidemiology-of-familial-aggregation-of-venous-thromboembolism
#17
Bengt Zöller, Xinjun Li, Henrik Ohlsson, Jianguang Ji, Ashfaque A Memon, Peter J Svensson, Karolina Palmér, Björn Dahlbäck, Jan Sundquist, Kristina Sundquist
Familial aggregation (clustering) of venous thromboembolism (VTE) is the clustering of VTE within a family. Though several genes, such as antithrombin, protein C, protein S, factor V, and prothrombin are associated with the familial clustering of VTE, these loci only partially explain the familial aggregation of VTE. The epidemiology of the familial aggregation of VTE exhibits typical characteristics of complex traits. The family history of VTE in first-degree relatives is associated with a two to three times increased familial relative risk (FRR)...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764880/extensive-computed-tomography-versus-limited-screening-for-detection-of-occult-cancer-in-unprovoked-venous-thromboembolism-a-multicenter-controlled-randomized-clinical-trial
#18
Paolo Prandoni, Enrico Bernardi, Fabio Dalla Valle, Adriana Visonà, Pietro F Tropeano, Carlo Bova, Eugenio Bucherini, Md Shahidul Islam, Andrea Piccioli
Patients with unprovoked venous thromboembolism (VTE) may harbor occult cancer. Whether an extensive diagnostic work-up for cancer has additional value over a more limited screening for detection of underlying malignancy in these patients is controversial. We performed a randomized multicenter trial to assess if in patients with unprovoked VTE, a computed tomography (CT)-based diagnostic strategy including thoracic, abdominal, and pelvic CT in combination with fecal occult blood test yields a higher cancer detection rate than a nonstandardized testing approach based on physicians' clinical judgment and patients' preferences...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27740860/management-of-idiopathic-venous-thromboembolism
#19
Benilde Cosmi
Idiopathic or unprovoked venous thromboembolism is an event occurring in the absence of any apparent provoking or triggering environmental risk factors, such as surgery, trauma, and immobilization. Areas covered: Unprovoked VTE can be associated with occult cancer, but only limited, and not extensive cancer screening, may be warranted, as the rate of occult cancer is low in such patients. Routine thrombophilia testing is not currently recommended as it does not influence the management of the disease. The duration of anticoagulation for unprovoked VTE after the first three months is still debated as the disease tends to recur regardless of treatment duration...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27696765/lung-function-respiratory-symptoms-and-venous-thromboembolism-risk-the-atherosclerosis-risk-in-communities-study
#20
Y Kubota, S J London, M Cushman, A M Chamberlain, W D Rosamond, S R Heckbert, N Zakai, A R Folsom
: Essentials The association of lung function with venous thromboembolism (VTE) is unclear. Chronic obstructive pulmonary disease (COPD) patterns were associated with a higher risk of VTE. Symptoms were also associated with a higher risk of VTE, but a restrictive pattern was not. COPD may increase the risk of VTE and respiratory symptoms may be a novel risk marker for VTE. SUMMARY: Background The evidence for the association between chronic obstructive pulmonary disease (COPD) and venous thromboembolism (VTE) is limited...
December 2016: Journal of Thrombosis and Haemostasis: JTH
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