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Unprovoked VTE

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https://www.readbyqxmd.com/read/28520199/economic-evaluation-of-strategies-for-restarting-anticoagulation-therapy-after-a-first-event-of-unprovoked-venous-thromboembolism
#1
M Monahan, J Ensor, D Moore, D Fitzmaurice, S Jowett
BACKGROUND: Following at least three months of anticoagulation therapy after a first unprovoked Venous Thromboembolism (VTE), there is uncertainty about the duration of therapy. Further anticoagulation therapy reduces the risk of having a potentially fatal recurrent VTE but at the expense of a higher risk of bleeding which can also be fatal. OBJECTIVE: An economic evaluation sought to estimate the long-term cost-effectiveness of using a decision rule for restarting anticoagulation therapy versus no extension of therapy in patients based on their risk of a further unprovoked VTE...
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
#2
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
#3
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
#4
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
#5
Luuk J J Scheres, Marjolein P A Brekelmans, Ludo F M Beenen, Harry R Büller, Suzanne C Cannegieter, Saskia Middeldorp
BACKGROUND: The risk of venous thromboembolism (VTE) differs between men and women. Some risk factors seem to influence the presenting location of VTE. Sex-specific differences in presenting VTE location have not been studied extensively. METHODS: We analysed data from the MEGA case-control study and the Hokusai-VTE study, and used published data from the RIETE registry. Data from patients with a symptomatic first VTE were included (MEGA n=4953; Hokusai-VTE n=6720; RIETE n=40028)...
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
#6
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
#7
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
#8
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...
April 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28407356/risk-of-cancer-after-anticoagulation-in-patients-with-unprovoked-venous-thromboembolism-an-observational-cohort-study
#9
L Eischer, M Kammer, L Traby, P A Kyrle, S Eichinger
BACKGROUND: Patients with venous thromboembolism (VTE) are at risk of subsequent cancer diagnosis. The risk is highest during the first six months. Reports on cancer rates thereafter are controversial. We aimed to assess long-term rates and risk factors of cancer in patients with VTE. METHODS AND RESULTS: We followed patients with a first unprovoked VTE after discontinuation of anticoagulation and excluded those with long-term antithrombotic therapy or major thrombophilia...
April 13, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28390645/anticoagulant-therapy-duration-in-favour-of-short-term-courses
#10
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
#11
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
#12
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
#13
MULTICENTER STUDY
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
#14
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
#15
MULTICENTER STUDY
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
#16
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...
April 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
#17
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
#18
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
#19
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...
May 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
#20
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...
March 2017: Thrombosis Research
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