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Unprovoked VTE

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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
#1
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
#2
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
#3
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...
August 21, 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
#4
L Farren-Dai, M Carrier, J Kovacs, M Rodger, M J Kovacs, G Le Gal
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 to an event that was unprovoked. OBJECTIVES: In this study we aimed to assess the association between remote exposure (3-12 months prior to VTE) to major VTE risk factors and the risk of recurrent VTE. METHODS: A post-hoc analysis of the REVERSE study, a prospective cohort of 646 patients with a first VTE, not provoked by a recent (< 3 months) major risk factor...
August 10, 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
#5
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
#6
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...
August 1, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28753478/extensive-screening-for-occult-malignancy-in-unprovoked-venous-thromboembolism-a-meta-analysis
#7
Min Zhou, Liyong Zhang, Yong Ding, Yonggang Wang, Dong Yan, Changpo Lin, Zhenyu Shi, Weiguo Fu
BACKGROUND: The present meta-analysis aimed to evaluate the efficacy and sensitivity of an extensive screening strategy for occult malignant diseases in patients with unprovoked venous thromboembolism (VTE). METHODS: We conducted a systematic search of PubMed, Cochrane, EMBASE, and relevant article references. Meta-analysis was used to pool weighted relative risks (RR) for the rate of missed diagnosis, all-cause mortality, and cancer-related mortality. Heterogeneity test was performed using the inconsistency index...
July 21, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#8
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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