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Unprovoked VTE

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https://www.readbyqxmd.com/read/28732457/long-term-recurrence-of-venous-thromboembolism-after-short-term-treatment-of-symptomatic-isolated-distal-deep-vein-thrombosis-a-cohort-study
#1
Marco P Donadini, Francesco Dentali, Samuela Pegoraro, Fulvio Pomero, Chiara Brignone, Luigina Guasti, Luigi Steidl, Walter Ageno
Isolated distal deep vein thrombosis (IDDVT) is a common clinical manifestation of venous thromboembolism (VTE). However, there are only scant and heterogeneous data available on the long-term risk of recurrent VTE after IDDVT, and the optimal therapeutic management remains uncertain. We carried out a retrospective cohort study of consecutive patients diagnosed with symptomatic IDDVT between 2004 and 2011, according to a predefined short-term treatment protocol (low molecular weight heparin (LMWH) for 4-6 weeks)...
July 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28730407/venous-thromboembolism-thrombosis-inflammation-and-immunothrombosis-for-clinicians
#2
REVIEW
Eduardo Vazquez-Garza, Carlos Jerjes-Sanchez, Aline Navarrete, Jorge Joya-Harrison, David Rodriguez
Venous thromboembolism (VTE) is a worldwide disease related with mortality, cardiovascular disability, impaired quality of life and, cause major long-term complications. Clinicians related to the acute and long-term patients care must be involved in the molecular mechanisms of thrombosis. The vessel wall and its inner lining of the endothelium are critical to the maintenance of a patent vasculature. After endothelial disruption, collagen (first line of endothelial defense) and intravascular tissue factor (second line of endothelial defense) are exposed to blood flow, starting the formation of a thrombus...
July 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28680172/direct-oral-anticoagulants-and-vitamin-k-antagonists-for-treatment-of-deep-venous-thrombosis-and-pulmonary-embolism-in-the-outpatient-setting-comparative-economic-evaluation
#3
Abdullah S Al Saleh, Patrick Berrigan, David Anderson, Sudeep Shivakumar
BACKGROUND: To date, there have been few economic evaluations, from a Canadian perspective, of direct oral anticoagulants (DOACs) for the prevention of recurrent venous thromboembolism (VTE) in patients with acute unprovoked VTE. As a result, there is a lack of consensus about which treatment strategy should be adopted in the clinical setting. OBJECTIVES: To assess the cost-effectiveness of currently approved anti-coagulant options, in terms of cost per quality-adjusted life-year (QALY) gained, for the prevention of recurrent VTE in patients with unprovoked events managed on an outpatient basis...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28659542/asymptomatic-lower-extremity-deep-vein-thrombosis%C3%A3-clinical-characteristics-management-strategies-and-long-term-outcomes
#4
Yugo Yamashita, Hiroki Shiomi, Takeshi Morimoto, Tomoya Yoneda, Chinatsu Yamada, Takeru Makiyama, Takao Kato, Naritatsu Saito, Satoshi Shizuta, Koh Ono, Takeshi Kimura
BACKGROUND: The prognosis of asymptomatic deep vein thrombosis (DVT) is uncertain and there is no consensus on the necessity of detection and treatment.Methods and Results:We retrospectively evaluated 300 patients with asymptomatic lower extremity DVT screened from 4,514 consecutive patients on ultrasound at Kyoto University Hospital between January 2010 and September 2015. The subjects had concomitant active cancer in 40%, unprovoked DVT in 59%, and distal DVT in 70%. The cumulative 5-year incidences of symptomatic recurrent venous thromboembolism (VTE); major bleeding; and all-cause death were 14...
June 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#5
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28601834/screening-for-cancer-in-patients-with-unprovoked-venous-thromboembolism-protocol-for-a-systematic-review-and-individual-patient-data-meta-analysis
#6
Nick van Es, Grégoire Le Gal, Hans-Martin Otten, Philippe Robin, Andrea Piccioli, Ramon Lécumberri, Luis Jara-Palomares, Piotr Religa, Viriginie Rieu, Matthew T Rondina, Mariëlle M Beckers, Paolo Prandoni, Pierre-Yves Salaun, Marcello Di Nisio, Patrick M Bossuyt, Harry R Büller, Marc Carrier
INTRODUCTION: Occult cancer is present in 4%-9% of patients with unprovoked venous thromboembolism (VTE). Screening for cancer may be considered in these patients, with the aim to diagnose cancers in an early, potentially curable stage. Information is needed about the risk of occult cancer, overall and in specific subgroups, additional risk factors and on the performance of different screening strategies. METHODS AND ANALYSIS: MEDLINE, Embase and CENTRAL databases were searched from November 2007 to January 2016 for prospective studies that had evaluated protocol-mandated screening for cancer in patients with unprovoked VTE and with at least 12 months' follow-up...
June 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28587726/occult-cancer-detection-in-patients-with-hemostatic-disorder-and-venous-thromboembolism
#7
Holleh Husseinzadeh, Marc Carrier
There are physiologic ties between Von Willebrand Factor (VWF) and circulating tumor cells. VWF appears to play a role in tumor biology, but it is unclear whether cancer behavior differs in Von Willebrand Disease. In patients presenting with venous thromboembolism (VTE), occult cancer is frequently considered as an underlying cause. The prevalence of occult cancer after provoked VTE is low (3%); therefore, cancer screening in these patients is not routinely recommended. In those with unprovoked VTE, occult cancer is more prevalent, estimated between 4 and 10%...
June 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28586924/scoring-systems-for-estimating-the-risk-of-recurrent-venous-thromboembolism
#8
Ilaria Nichele, Alberto Tosetto
The risk of recurrence after suspension of anticoagulant treatment in patients with a first episode of unprovoked venous thromboembolism (VTE) is highly variable from patient to patient. Not all patients are candidates for life-long anticoagulant therapy, essentially because there remain concerns for such an option regarding hemorrhagic complications and clinical monitoring. Thus, the "treat all" approach may be inadequate for some patients at low risk of relapse. Proper assessment of the recurrence risk may be helpful to decide the optimal therapeutic strategy in such patients...
July 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28570648/performance-of-18f-fluorodesoxyglucose-positron-emission-tomography-combined-with-low-dose-computed-tomography-for-cancer-screening-in-patients-with-unprovoked-venous-thromboembolism
#9
Philippe Robin, Pierre-Yves Le Roux, Karine Lacut, Benjamin Planquette, Nathalie Prévot-Bitot, Christian Lavigne, Jean Pastre, Adel Merah, Grégoire Le Gal, Pierre-Yves Salaun
PURPOSE: Small series have suggested that Fluorodesoxyglucose Positron-Emission-Tomography with Computed-Tomography (FDG-PET/CT) is feasible to screen for cancer in patients with unprovoked venous thromboembolism (VTE), but without validation in a large population. The aim was to assess diagnostic accuracy indices of FDG-PET/CT for occult cancer diagnosis in patients with unprovoked VTE. MATERIALS AND METHODS: We analysed patients from the FDG-PET/CT group of a randomized trial that compared a screening strategy based on FDG-PET/CT with a limited screening strategy for occult malignancy detection in patients with unprovoked VTE...
2017: PloS One
https://www.readbyqxmd.com/read/28520199/economic-evaluation-of-strategies-for-restarting-anticoagulation-therapy-after-a-first-event-of-unprovoked-venous-thromboembolism
#10
M Monahan, J Ensor, D Moore, D Fitzmaurice, S Jowett
Essentials Correct duration of treatment after a first unprovoked venous thromboembolism (VTE) is unknown. We assessed when restarting anticoagulation was worthwhile based on patient risk of recurrent VTE. When the risk over a one-year period is 17.5%, restarting is cost-effective. However, sensitivity analyses indicate large uncertainty in the estimates. SUMMARY: Background Following at least 3 months of anticoagulation therapy after a first unprovoked venous thromboembolism (VTE), there is uncertainty about the duration of therapy...
May 18, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28468786/long-term-effects-of-unprovoked-venous-thromboembolism-on-mortality-and-major-cardiovascular-events
#11
Wei-Ting Chang, Chia-Li Chang, Chung-Han Ho, Chon-Seng Hong, Jhi-Joung Wang, Zhih-Cherng Chen
BACKGROUND: Patients with unprovoked venous thromboembolism (VTE) are at an increased risk of mortality, but whether their cardiovascular risks also increase remains to be determined. We aimed to investigate the factors associated with overall mortality and major adverse cardiovascular events in patients with unprovoked VTE. METHODS AND RESULTS: We identified 2154 patients newly diagnosed with unprovoked VTE from Taiwan's National Health Insurance Database between 2000 and 2013, excluding those with reversible etiologies, underlying cancer, or autoimmune diseases...
May 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28460260/additional-testing-following-screening-strategies-for-occult-malignancy-diagnosis-in-patients-with-unprovoked-venous-thromboembolism
#12
Philippe Robin, Pierre-Yves Le Roux, Emmanuelle Le Moigne, Benjamin Planquette, Nathalie Prévot-Bitot, Pierre-Marie Roy, Jean Pastre, Adel Merah, Francis Couturaud, Grégoire Le Gal, Pierre-Yves Salaun
(18)F-Fluorodesoxyglucose Positron-Emission-Tomography combined with Computed-Tomography (FDG PET/CT) might be an attractive tool for cancer screening in patients with venous thromboembolism (VTE), allowing non-invasive whole-body imaging. One of the frequent criticisms to the use of FDG PET/CT for screening is the potential for false positive results leading to unnecessary/invasive investigations. Our aim was to compare the frequency and invasiveness of additional testing following extensive and limited screening strategies for occult malignancy in patients with unprovoked VTE...
April 25, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28447414/review-of-d-dimer-testing-good-bad-and-ugly
#13
REVIEW
L-A Linkins, S Takach Lapner
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28440013/sex-specific-differences-in-the-presenting-location-of-a-first-venous-thromboembolism
#14
L J J Scheres, M P A Brekelmans, L F M Beenen, H R Büller, S C Cannegieter, S Middeldorp
Essentials Whether the location of venous thromboembolism (VTE) differs between the sexes is not known. Pulmonary embolism as presenting location was relatively more common in women than in men. The difference was consistent among age groups and most prominent in unprovoked VTE. The underlying mechanism remains to be elucidated. SUMMARY: Background The risk of venous thromboembolism (VTE) differs between men and women. Some risk factors seem to influence the presenting location of VTE...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28439954/survival-and-recurrent-venous-thromboembolism-in-patients-with-first-proximal-or-isolated-distal-deep-vein-thrombosis-and-no-pulmonary-embolism
#15
S Barco, M Corti, A Trinchero, C Picchi, C Ambaglio, S V Konstantinides, F Dentali, M Barone
Essentials The long-term risk of recurrence and death after distal deep vein thrombosis (DVT) is uncertain. We included subjects with first proximal or isolated distal DVT (IDDVT) and no pulmonary embolism. The risk of symptomatic and asymptomatic recurrence is lower after IDDVT (vs. proximal). IDDVT may be associated with a lower long-term risk of death, especially after unprovoked DVT. SUMMARY: Background A few studies have focused on the risk of recurrence after first acute isolated distal deep vein thrombosis (IDDVT) compared with proximal DVT (PDVT), whereas the incremental risk of death has never been explored beyond the first 3 years after acute event...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28411120/effectiveness-and-safety-of-rivaroxaban-and-warfarin-in-patients-with-unprovoked-venous-thromboembolism-a-propensity-matched-nationwide-cohort-study
#16
Torben B Larsen, Flemming Skjøth, Jette N Kjældgaard, Gregory Y H Lip, Peter B Nielsen, Mette Søgaard
BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism are collectively known as venous thromboembolism (VTE), which is a common vascular disease and a major cause of morbidity and mortality worldwide. We compare effectiveness and safety of rivaroxaban versus warfarin in a prospective cohort of routine care patients with incident unprovoked VTE. METHODS: In this propensity-matched cohort study, we linked nationwide Danish health registries to identify all patients with a first hospital diagnosis of unprovoked VTE who were new users of rivaroxaban or warfarin...
May 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28407492/residual-vein-thrombosis-and-serial-d-dimer-for-the-long-term-management-of-patients-with-deep-venous-thrombosis
#17
Paolo Prandoni, Valentina Vedovetto, Maurizio Ciammaichella, Eugenio Bucherini, Sara Corradini, Iolanda Enea, Benilde Cosmi, Nicola Mumoli, Adriana Visonà, Giovanni Barillari, Carlo Bova, Roberto Quintavalla, Nello Zanatta, Simona Pedrini, Sabina Villalta, Giuseppe Camporese, Sofie Testa, Roberto Parisi, Cecilia Becattini, Stefano Cuppini, Vittorio Pengo, Gualtiero Palareti
BACKGROUND: The optimal long-term strategy for preventing recurrent venous thromboembolism (VTE) in patients with deep-vein thrombosis (DVT) is uncertain. METHODS: In 620 consecutive outpatients with a first proximal DVT who had completed at least three months of anticoagulation (unprovoked in 483, associated with minor risk factors in 137), the ultrasound presence of residual vein thrombosis (RVT) was assessed and defined as an incompressibility of at least 4mm...
June 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28407356/risk-of-cancer-after-anticoagulation-in-patients-with-unprovoked-venous-thromboembolism-an-observational-cohort-study
#18
L Eischer, M Kammer, L Traby, P A Kyrle, S Eichinger
Essentials Data on long-term cancer risk are controversial in patients with venous thromboembolism (VTE). We assessed long-term rates and risk factors of cancer in patients with VTE. Cancer risk after anticoagulation is not higher in VTE patients than in the general population. VTE recurrence is not predictive of a future cancer diagnosis. SUMMARY: Background Patients with venous thromboembolism (VTE) are at risk of having a subsequent cancer diagnosis. The risk is highest during the first 6 months...
April 13, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28390645/anticoagulant-therapy-duration-in-favour-of-short-term-courses
#19
J A Nieto Rodríguez, J C Ramírez Luna
In recent years, we have observed a tendency to extend anticoagulant therapy for patients with venous thromboembolism disease (VTE). This practice exposes patients to a greater risk of severe and fatal haemorrhage, which, in certain conditions, outweighs the benefits related to the reduction in disease recurrence. This review examines the evidence in favour of reducing anticoagulant therapy as much as possible, especially for patients with VTE "caused" by temporary risk factors, with isolated deep vein thrombosis and with unprovoked VTE and a high risk of haemorrhage...
April 5, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28321922/retrospective-evaluation-of-venous-thromboembolism-are-all-transient-provoking-events-the-same
#20
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
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