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Unprovoked VTE

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https://www.readbyqxmd.com/read/29331940/screening-and-functional-exploration-of-prothrombin-arg596-related-mutations-in-chinese-venous-thromboembolism-patients
#1
Xi Wu, Lei Li, Qiulan Ding, Xuefeng Wang, Fang Wu, Wenman Wu
AIMS: Dysfunctional prothrombin residue Arg596 associated mutation has been found to precipitate venous thromboembolism (VTE). In the current study we investigated the prevalence of Arg596 associated mutations in Chinese patients with VTE and explored the functional impact of Arg596Gln mutation on coagulation function in affected patients. METHODS: Prothrombin clotting activity was measured in 267 unrelated patients with unprovoked VTE. Patients with moderately decreased activities underwent further analysis of the F2 gene...
January 13, 2018: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29303099/-cancer-detection-following-unprovoked-vte-case-history-and-physical-examination-are-still-of-foremost-importance
#2
G J Geersing
The relation between cancer and thrombosis is well known. In fact, the presence of an occult malignancy in patients with unprovoked venous thromboembolism (VTE) is named after a famous 19th century French physician; it is called Trousseau's sign. In this commentary, I elaborate upon findings from a recent individual patient data meta-analysis on Trousseau's sign. This study demonstrated that extensive screening to unmask an occult malignancy in unprovoked VTE is no better than 'simple' history taking and physical examination, alongside age-specific and gender-specific national cancer screening e...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29301920/risk-factors-for-recurrent-venous-thromboembolism-after-unprovoked-pulmonary-embolism-the-padis-pe-randomised-trial
#3
Cécile Tromeur, Olivier Sanchez, Emilie Presles, Gilles Pernod, Laurent Bertoletti, Patrick Jego, Elisabeth Duhamel, Karine Provost, Florence Parent, Philippe Robin, Lucile Deloire, Florent Leven, Fanny Mingant, Luc Bressollette, Pierre-Yves Le Roux, Pierre-Yves Salaun, Michel Nonent, Brigitte Pan-Petesch, Benjamin Planquette, Philippe Girard, Karine Lacut, Solen Melac, Patrick Mismetti, Silvy Laporte, Guy Meyer, Dominique Mottier, Christophe Leroyer, Francis Couturaud
We aimed to identify risk factors for recurrent venous thromboembolism (VTE) after unprovoked pulmonary embolism.Analyses were based on the double-blind randomised PADIS-PE trial, which included 371 patients with a first unprovoked pulmonary embolism initially treated during 6 months who were randomised to receive an additional 18 months of warfarin or placebo and followed up for 2 years after study treatment discontinuation. All patients had ventilation/perfusion lung scan at inclusion (i.e. at 6 months of anticoagulation)...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29297660/overview-of-venous-thromboembolism
#4
Haley M Phillippe
Venous thromboembolism (VTE) describes the diagnoses of deep vein thrombosis (DVT) or pulmonary embolism (PE). DVT is the formation of thrombi in the deep veins, most commonly the large veins of the legs or pelvis. PE develops when thrombi dislodge from clots in vein walls and travel through the heart to pulmonary arteries. In many patients, the presenting manifestation of PE is sudden death. VTE may be categorized as provoked or unprovoked. This categorization influences the risk of recurrent VTE and duration of anticoagulation therapy...
December 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29248890/thromboembolismpeaking-3-months-after-starting-testosterone-therapy-testosterone-thrombophilia-interactions
#5
Charles J Glueck, Naila Goldenberg, Ping Wang
We assessed time of thrombotic events (venous thromboembolism (VTE)) after starting testosterone therapy (TT) in 21 men who sustained 23 VTE. The density of thrombotic events was greatest at 3 months after starting TT, with a rapid decline in events by 10 months. The 21 cases with VTE on TT differed from 110 patient controls with unprovoked VTE, not taking TT (VTE-no TT) for Factor V Leiden heterozygosity (FVL) (33 per cent vs 13 per cent, P=0.037), for high lipoprotein (a) (Lp(a)) (55 per cent vs 17 per cent, P=0...
December 15, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29244199/secondary-prevention-of-recurrent-venous-thromboembolism-after-initial-oral-anticoagulation-therapy-in-patients-with-unprovoked-venous-thromboembolism
#6
REVIEW
Lindsay Robertson, Su Ern Yeoh, Ahmad Ramli
BACKGROUND: Currently, little evidence is available on the length and type of anticoagulation used for extended treatment for prevention of recurrent venous thromboembolism (VTE) in patients with unprovoked VTE who have completed initial oral anticoagulation therapy. OBJECTIVES: To compare the efficacy and safety of available oral therapeutic options (aspirin, warfarin, direct oral anticoagulants (DOACs)) for extended thromboprophylaxis in adults with a first unprovoked VTE, to prevent VTE recurrence after completion of an acceptable initial oral anticoagulant treatment period, as defined in individual studies...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29183221/duration-of-anticoagulant-therapy-in-pediatric-venous-thromboembolism-current-approaches-and-updates-from-randomized-controlled-trials
#7
Cristina Tarango, Sam Schulman, Marisol Betensky, Neil A Goldenberg
Compared with the incidence of venous thromboembolism in the adult population, pediatric VTE is rare. Yet, recent data suggest that the incidence of VTE in children is increasing, and little is known about the optimal duration of anticoagulation in pediatrics. Areas covered: This review summarizes current evidence-based adult recommendations and associated clinical trials from which current guidelines on the duration of anticoagulation in children have been extrapolated. It also discusses pediatric expert consensus-based guidelines and current pediatric clinical trials on duration of therapy in pediatric VTE...
January 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29169908/increased-risk-and-severity-of-unprovoked-venous-thromboembolism-with-clustering-cardiovascular-risk-factors-for-atherosclerosis-results-of-the-remotev-registry
#8
S Gaertner, E-M Cordeanu, C Mirea, A-S Frantz, C Auger, P Bilbault, P Ohlmann, V Schini-Kerth, D Stephan
BACKGROUND: The role of cardiovascular risk factors (CVRF) for atherosclerosis in venous thromboembolic disease (VTE) is controversial. The aim of this study was to evaluate the impact of CVRF and their cumulative effects on the occurrence of unprovoked VTE, severity, recurrence and survival. METHODS AND RESULTS: This is a prospective cohort from the REMOTEV registry including all consecutively hospitalized patients for acute symptomatic VTE. From November 2013 to December 2016, 515 patients with 6months follow-up (FU) were selected for the analysis...
November 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29045005/natural-antibodies-to-oxidation-specific-epitopes-innate-immune-response-and-venous-thromboembolic-disease
#9
S Eichinger, P A Kyrle, M Kammer, L Eischer, M Ozsvar Kozma, C J Binder
BACKGROUND AND OBJECTIVES: Natural antibodies to oxidation-specific epitopes protect from atherothrombotic events. Whether mechanisms of innate immunity are relevant in the pathogenesis of venous thromboembolism (VTE) is unknown. PATIENTS/METHODS: We measured plasma levels of IgM antibodies to oxidized low-density lipoproteins (OxLDL) and phosphocholine (PC) by enzyme linked immune assay in 663 patients with unprovoked VTE, who were prospectively followed after discontinuation of anticoagulation for a median of 8...
October 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29040284/the-prevalence-and-clinical-manifestation-of-hereditary-thrombophilia-in-korean-patients-with-unprovoked-venous-thromboembolisms
#10
Su Yeon Lee, Eun Kyoug Kim, Min Sun Kim, Sun Hye Shin, Haseong Chang, Shin Yi Jang, Hee-Jin Kim, Duk-Kyung Kim
BACKGROUND: Hereditary thrombophilia (HT) is a genetic predisposition to thrombosis. Asian mutation spectrum of HT is different from Western ones. We investigated the incidence and clinical characteristics of HT in Korean patients with unprovoked venous thromboembolism (VTE). METHODS: Among 369 consecutive patients with thromboembolic event who underwent thrombophilia tests, we enrolled 222 patients diagnosed with unprovoked VTE. The presence of HT was confirmed by DNA sequencing of the genes that cause deficits in natural anticoagulants (NAs)...
2017: PloS One
https://www.readbyqxmd.com/read/29034033/novel-anticoagulant-therapy-of-venous-thromboembolism-current-status-and-future-directions
#11
REVIEW
Mashio Nakamura, Norikazu Yamada, Masaaki Ito
The first-line treatment of venous thromboembolisms (VTE) is anticoagulant therapy, and unfractionated heparin and warfarin are used in Japan. However, as both drugs require dosage adjustments that are difficult, VTE recurrences occur relatively frequently, and hemorrhagic complications are extremely common. The parenteral factor Xa inhibitor fondaparinux and the direct oral anticoagulants (DOACs) edoxaban, rivaroxaban, and apixaban have recently become available as treatments for VTE in Japan. These novel anticoagulants have more stable effects than traditional therapies and are thus considered safer and more effective than the traditional agents...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28978463/risk-factors-of-occult-malignancy-in-patients-with-unprovoked-venous-thromboembolism
#12
Philippe Robin, Pierre-Yves Le Roux, Cécile Tromeur, Benjamin Planquette, Nathalie Prévot-Bitot, Christian Lavigne, Jean Pastre, Adel Merah, Francis Couturaud, Grégoire Le Gal, Pierre-Yves Salaun
Venous thromboembolism (VTE) can occur as the first manifestation of an underlying occult malignancy. It remains unclear whether or not a better selection of high risk patients might lead to more efficient occult cancer screening strategies. Our aim was to assess the predictors of occult malignancy diagnosis in patients with unprovoked VTE. Univariate analyses were performed to assess the effect of candidate predictors on occult cancer detection in patients enrolled in a prospective, multicenter, randomized, controlled study (MVTEP study) whose primary aim was to compare a limited screening strategy with a strategy combining limited screening and FDG PET/CT in patients with unprovoked VTE...
September 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28975323/herdoo2-identified-women-at-low-risk-for-recurrence-after-5-to-12-mo-of-anticoagulation-for-a-first-unprovoked-vte
#13
Paul Kruger, John Eikelboom
No abstract text is available yet for this article.
September 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28939565/long-term-risk-of-recurrence-after-discontinuing-anticoagulants-for-a-first-unprovoked-venous-thromboembolism-protocol-for-a-systematic-review-and-meta-analysis
#14
Faizan Khan, Alvi Rahman, Marc Carrier, Clive Kearon, Sam Schulman, Francis Couturaud, Paolo Prandoni, Sabine Eichinger, Cecilia Becattini, Giancarlo Agnelli, Harry R Büller, Timothy A Brighton, Gualtiero Palareti, Laurent Pinede, Elham Sabri, Brian Hutton, George A Wells, Marc A Rodger
INTRODUCTION: For patients with a first unprovoked venous thromboembolism (VTE), the optimal duration of anticoagulation is a crucial clinical dilemma which has yet to be resolved. The decision to stop anticoagulant therapy (AT) after the initial 3-6 months or to continue AT indefinitely, is primarily governed by the long-term risk of recurrence when treatment is discontinued. This risk however, is not well established, hindering decision making. METHODS AND ANALYSIS: We will conduct a systematic review and a meta-analysis of studies involving patients diagnosed with a first, symptomatic unprovoked VTE or VTE provoked by minor transient risk factors, who have completed at least 3 months of initial AT; and who were followed-up for standardised time intervals of 1, 2, 5, 10 and 20 years (±3 months) after stopping AT...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28832905/effect-of-testing-for-cancer-on-cancer-and-venous-thromboembolism-vte-related-mortality-and-morbidity-in-people-with-unprovoked-vte
#15
REVIEW
Lindsay Robertson, Su Ern Yeoh, Gerard Stansby, Roshan Agarwal
BACKGROUND: Venous thromboembolism (VTE) is a collective term for two conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). A proportion of people with VTE have no underlying or immediately predisposing risk factors and the VTE is referred to as unprovoked. Unprovoked VTE can often be the first clinical manifestation of an underlying malignancy. This has raised the question of whether people with an unprovoked VTE should be investigated for an underlying cancer. Treatment for VTE is different in cancer and non-cancer patients and a correct diagnosis would ensure that people received the optimal treatment for VTE to prevent recurrence and further morbidity...
August 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28828492/screening-for-occult-cancer-in-patients-with-unprovoked-venous-thromboembolism-a-systematic-review-and-meta-analysis-of-individual-patient-data
#16
REVIEW
Nick van Es, Grégoire Le Gal, Hans-Martin Otten, Philippe Robin, Andrea Piccioli, Ramón Lecumberri, Luis Jara-Palomares, Piotr Religa, Virginie Rieu, Matthew Rondina, Mariëlle M Beckers, Paolo Prandoni, Pierre-Yves Salaun, Marcello Di Nisio, Patrick M Bossuyt, Harry R Büller, Marc Carrier
Background: Screening for cancer in patients with unprovoked venous thromboembolism (VTE) often is considered, but clinicians need precise data on cancer prevalence, risk factors, and the effect of different types of screening strategies. Purpose: To estimate the prevalence of occult cancer in patients with unprovoked VTE, including in subgroups of different ages or those that have had different types of screening. Data Sources: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to 19 January 2016...
September 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28803491/optimal-long-term-pharmacological-treatment-of-patients-with-venous-thromboembolism-that-was-unprovoked-or-associated-with-weak-risk-factors
#17
REVIEW
Gualtiero Palareti
Unprovoked venous thromboembolism (VTE) tend to recur. Many factors, patient- or event-related, influence the individual risk of recurrence. After initial and long-term (usually for 3-6 months) anticoagulant therapy, extended anticoagulation has been recommended in patients at high risk of recurrence, provided they do not have a high risk of bleeding. Areas covered: The effect of different risk factors on the risk of recurrence is discussed, as well as risk factors for bleeding. The estimation of individual balance between these two risks is crucial to decide which can be the best treatment duration in single patients...
October 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28795538/association-between-remote-major-venous-thromboembolism-risk-factors-and-the-risk-of-recurrence-after-a-first-unprovoked-episode
#18
L Farren-Dai, M Carrier, J Kovacs, M Rodger, M J Kovacs, G Le Gal
Essentials Is remote exposure to major venous thromboembolism (VTE) risk factor related to lower recurrence? We analyzed data from the REVERSE study, a cohort of patients with no recent major risk factor. We found no association between remote risk factors and the risk of recurrence. Patients with remote VTE risk factor should be managed as having had an unprovoked VTE. SUMMARY: Background It has been shown that the risk of recurrence of venous thromboembolism (VTE) is significantly lower when provoked by a major risk factor such as surgery or trauma compared with an event that was unprovoked...
October 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28780342/e-selectin-and-sicam-1-biomarkers-of-endothelial-function-predict-recurrence-of-venous-thromboembolism
#19
Olga Dzikowska-Diduch, Justyna Domienik-Karłowicz, Elżbieta Górska, Urszula Demkow, Piotr Pruszczyk, Maciej Kostrubiec
BACKGROUND: Risk factors for atherosclerosis and venous thromboembolism (VTE) overlap and are mostly associated with endothelial dysfunction (ED). We hypothesized that ED is present in patients after the first episode of acute pulmonary embolism (APE) and predicts the risk of VTE recurrence. DESIGN AND METHODS: Patients, at least 6months after the first episode of symptomatic, confirmed APE were included in this case-control study. The exclusion criteria were risk factors for cardiovascular diseases and other conditions associated with endothelial dysfunction...
July 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28762665/external-validation-of-the-dash-prediction-rule-a-retrospective-cohort-study
#20
A Tosetto, S Testa, I Martinelli, D Poli, B Cosmi, C Lodigiani, W Ageno, V De Stefano, A Falanga, I Nichele, O Paoletti, P Bucciarelli, E Antonucci, C Legnani, E Banfi, F Dentali, F Bartolomei, L Barcella, G Palareti
Essentials Predicting recurrences may guide therapy after unprovoked venous thromboembolism (VTE). We evaluated the DASH score in 827 patients with unprovoked VTE to verify prediction accuracy. A DASH score ≤ 1 had a cumulative recurrence risk at 1 year of 3.6%, as predicted by the model. The DASH score performed better in younger (< 65 years old) subjects. SUMMARY: Background The DASH prediction model has been proposed as a guide to identify patients at low risk of recurrence of venous thromboembolism (VTE), but has never been validated in an independent cohort...
October 2017: Journal of Thrombosis and Haemostasis: JTH
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