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Unprovoked VTE

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https://www.readbyqxmd.com/read/29772489/prevention-of-venous-thromboembolism-in-pregnant-patients-with-a-history-of-venous-thromboembolic-disease-a-retrospective-cohort-study
#1
Alejandro Lazo-Langner, Fatimah Al-Ani, Sarah Weisz, Camilla Rozanski, Martha Louzada, Judy Kovacs, Michael J Kovacs
BACKGROUND: Optimal prophylactic strategies in pregnant women with a history of venous thromboembolism (VTE) are unknown. PATIENTS AND METHODS: We conducted a retrospective cohort study of consecutive pregnant patients with a previous VTE history. Patients were followed until 6 weeks postpartum. Patients with a previous unprovoked event (including antepartum VTE) received antenatal prophylaxis, mostly with low dose low molecular weight heparin (LMWH). All patients received prophylaxis for six weeks after delivery...
May 5, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29703487/revisiting-occult-cancer-screening-in-patients-with-unprovoked-venous-thromboembolism
#2
Philippe Robin, Marc Carrier
Unprovoked venous thromboembolism (VTE) can be the first manifestation of an unknown cancer. A recently published individual patient data meta-analysis (IPDMA) reported a prevalence of occult cancer detection of 5.2% (95% CI, 4.1% to 6.5%) over a one-year follow-up period, approximately 50% lower than the previously reported 12-month period prevalence. Although an extensive screening strategy was associated with a 2-fold higher probability of cancer detection at initial screening in the IPDMA, not enough evidence exists yet to support the routine use of these tests in patients with unprovoked VTE...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29678687/clinical-characteristics-and-outcomes-of-patients-with-multiple-simultaneous-superficial-vein-thrombi
#3
Rishi Chopra, Luis R Leon, Nicos Labropoulos
BACKGROUND: Although unprovoked superficial venous thrombosis (SVT) has traditionally been considered a local, benign disorder, recent studies demonstrate that patients with SVT are at significant risk for deep venous thrombosis, pulmonary embolism, and other venous thromboembolism (VTE) events. Nevertheless, clinical management remains widely inconsistent. Moreover, patients with multiple, unprovoked SVTs of noncommunicating anatomic sites have not been previously described, and they may be at even increased risk for adverse outcomes...
April 17, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29669439/predictive-value-of-oxidized-low-density-lipoprotein-%C3%AE-2-glycoprotein-i-complexes-oxldl-%C3%AE-2-gpi-in-nonautoimmune-atherothrombosis
#4
Paul R J Ames, Giuseppe Di Girolamo, Giovanna D'Andrea, Luis R Lopez, Giovanni Gaeta, Luigi Iannaccone, Maurizio Maraglione
INTRODUCTION: Lipid oxidation is a definite feature of atherosclerosis, and oxidized low-density lipoprotein (oxLDL) is not only highly immunogenic but toxic to several cell types. Beta-2-glycoprotein-I (β2 GPI) dampens oxLDL toxicity by forming binary oxLDL/β2 GPI complexes. We evaluated whether circulating oxLDL/β2 GPI complexes are associated to atherosclerosis-related events (ARE) and to venous thromboembolism (VTE). METHODS: In a cross-sectional case-control study, cases were (a) 57 consecutive patients (male/female [M/F] 33/24, mean age 57 [10] years) attending a thrombosis unit for ARE (myocardial infarction [MI] n = 20, peripheral vascular disease n = 7, and ischemic strokes n = 30); (b) 52 consecutive patients (M/F 22/30, mean age 55 [17] years) attending the same unit for unprovoked (VTE); (c) normal controls comprised 90 participants (M/F 35/55, mean age 41 [15] years); and (d) oxLDL/β2 GPI complexes were measured by immunoassay and resulting levels divided into quartiles...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29601145/comparative-efficacy-and-safety-of-low-intensity-warfarin-therapy-in-preventing-unprovoked-recurrent-venous-thromboembolism-a-systematic-review-and-meta-analysis
#5
REVIEW
Rong Jiang, Yu Shi, Rui Zhang, Bigyan Pudasain, Lan Wang, Qin-Hua Zhao, Ping Yuan, Jian Guo, Chang-Tai Zhu, Jin-Ming Liu
Background:Although there exists potential risk of bleeding, extended "lifelong" conventional-intensity (international normalized ratio (INR): 2.0-3.0) warfarin anticoagulation is recommended for unprovoked venous thromboembolism (VTE) patients due to risk of recurrent VTE. Whether long-term low-intensity (INR: 1.5-2.0) warfarin therapy reduced the risk of major bleeding without substantially lowered antithrombotic efficacy is not well understood. The aim of this study was to perform a systematic review and meta-analysis to evaluate the risk-benefits of low-intensity warfarin therapy...
March 30, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29576597/anticoagulation-therapy-for-venous-thromboembolism-in-the-real-world-from-the-command-vte-registry
#6
Yugo Yamashita, Takeshi Morimoto, Hidewo Amano, Toru Takase, Seiichi Hiramori, Kitae Kim, Takashi Konishi, Masaharu Akao, Yohei Kobayashi, Takeshi Inoue, Maki Oi, Toshiaki Izumi, Kotaro Takahashi, Tomohisa Tada, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Hiroshi Sakai, Syunsuke Saga, Tomoki Sasa, Jiro Sakamoto, Chinatsu Yamada, Minako Kinoshita, Kiyonori Togi, Tomoyuki Ikeda, Katsuhisa Ishii, Kazuhisa Kaneda, Hiroshi Mabuchi, Hideo Otani, Kensuke Takabayashi, Mamoru Takahashi, Hiroki Shiomi, Takeru Makiyama, Koh Ono, Takeshi Kimura
BACKGROUND: Venous thromboembolism (VTE) has a long-term risk of recurrence, which can be prevented by anticoagulation therapy.Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive patients with acute symptomatic VTE between January 2010 and August 2014. The entire cohort was divided into the transient risk (n=855, 28%), unprovoked (n=1,477, 49%), and cancer groups (n=695, 23%). The rate of anticoagulation discontinuation was highest in the cancer group (transient risk: 37...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29558509/validation-of-a-prognostic-score-for-hidden-cancer-in-unprovoked-venous-thromboembolism
#7
Luis Jara-Palomares, Remedios Otero, David Jimenez, Juan Manuel Praena-Fernandez, Carme Font, Conxita Falga, Silvia Soler, David Riesco, Peter Verhamme, Manuel Monreal
The usefulness of a diagnostic workup for occult cancer in patients with venous thromboembolism (VTE) is controversial. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to perform a nested case-control study to validate a prognostic score that identifies patients with unprovoked VTE at increased risk for cancer. We dichotomized patients as having low- (≤2 points) or high (≥3 points) risk for cancer, and tried to validate the score at 12 and 24 months. From January 2014 to October 2016, 11,695 VTE patients were recruited...
2018: PloS One
https://www.readbyqxmd.com/read/29548526/antipsychotic-drugs-and-the-risk-of-recurrent-venous-thromboembolism-a-prospective-cohort-study
#8
L M Mollard, R Le Mao, C Tromeur, E Le Moigne, M Gouillou, B Pan-Petesch, A Delluc, F Couturaud, K Lacut
BACKGROUND: Numerous studies have suggested that antipsychotic drugs are associated with an increased risk for a first episode of venous thromboembolism (VTE). However, after anticoagulation discontinuation, the impact of antipsychotic drugs on the risk of recurrent VTE (rVTE) remains unknown. OBJECTIVE: To estimate the risk of rVTE in association with antipsychotic drugs. METHODS: Between May 2000 and December 2012, we included all consecutive patients with a first unprovoked symptomatic VTE and who discontinued anticoagulation...
March 13, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29541810/nationwide-study-on-the-risk-of-unprovoked-venous-thromboembolism-in-non-traumatic-osteonecrosis-of-femoral-head
#9
Pei-Hsun Sung, Hsin-Ju Chiang, Yao-Hsu Yang, John Y Chiang, Chi-Jen Chen, Hon-Kan Yip, Mel S Lee
PURPOSE: Endothelial dysfunction is a risk factor for osteonecrosis of femoral head (ONFH) and venous thromboembolism (VTE) [defined as deep venous thrombosis (DVT) or pulmonary embolism (PE)]. However, the risk of unprovoked VTE in non-traumatic ONFH patients remains unclear. METHODS: We investigated the relationship between ONFH and VTE using Taiwan National Health Insurance Research Database (NHIRD). Between 1997 and 2010, a total of 1514 non-traumatic ONFH patients were identified from 1,000,000 general populations after excluding initially concomitant diagnoses of DVT and PE, and subjects undergoing lower limb surgery within one year since enrollment...
March 14, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29522910/real-world-incidence-of-cancer-following-a-first-unprovoked-venous-thrombosis-results-from-the-epigetbo-study
#10
Aurélien Delluc, Jean-Christiophe Ianotto, Cécile Tromeur, Claire De Moreuil, Francis Couturaud, Karine Lacut, Emmanuelle Le Moigne, Patrick Louis, Jérémie Thereaux, Jean-Philippe Metges, Dominique Mottier
BACKGROUND: Venous thromboembolism (VTE) can be the first manifestation of cancer; however, the current incidence of malignancy in unselected patients with first unprovoked VTE needs to be confirmed. MATERIAL AND METHODS: Between March 1st, 2013 and February 28th, 2015 we included and followed-up all patients living in the Brest district, France, who were seen in hospitals or the community for a first symptomatic unprovoked VTE event. The primary study outcome was the one-year incidence of cancer...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29518638/thrombophilia-testing-in-children-what-and-when-should-be-tested
#11
REVIEW
Ulrike Nowak-Göttl, Heleen van Ommen, Gili Kenet
Venous thrombosis (VTE) in children is gaining increased awareness and apart from underlying medical conditions, recently reported systematic reviews on pediatric VTE (70% provoked) have shown significant associations between thrombosis and presence of inherited thrombophilic risk factors (IT), such as protein C-, protein S- and antithrombin deficiency, mutations of factor 5 (F5: rs6025) and factor 2 (F2: rs1799963), even more pronounced when combined IT were involved. Although we have learned more about the pathophysiology of VTE with the increased discovery of IT evidence is still lacking as to whether IT influence the clinical outcome in pediatric VTE...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29502769/evidence-based-therapies-for-pharmacologic-prevention-and-treatment-of-acute-deep-vein-thrombosis-and-pulmonary-embolism
#12
REVIEW
Ben Jacobs, Peter K Henke
Venous thromboembolism (VTE) remains a significant mortal and morbid disease. The major risks have not changed and many patients present with unprovoked VTE disease. Prevention of VTE in hospitalized patients depends on comprehensive risk factor assessment, with an individual risk score. Proper and timely prophylaxis with mechanical, pharmacologic, or both is then effective. Treatment of VTE with parenteral anticoagulation followed by either a direct oral anticoagulant or warfarin is standard to reduce risk of VTE recurrence and death...
April 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29502768/new-trends-in-anticoagulation-therapy
#13
REVIEW
Margaret Smith, Glenn Wakam, Thomas Wakefield, Andrea Obi
Anticoagulation pharmacy has been dramatically altered with US Food and Drug Administration (FDA) approval of 5 direct oral anticoagulants, 1 novel reversal agent and, a second designated for fast-track approval. Trial data surrounding current trends in anticoagulant choice for VTE, reversal, and bridging are constantly redefining practice. Extended therapy for unprovoked VTE has expanded to include low-dose direct oral anticoagulants, aspirin, and the use of the HERDOO2 system to identify women who can stop anticoagulant therapy without increased risk of recurrent VTE...
April 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29490924/antiphospholipid-antibodies-and-recurrent-thrombosis-after-a-first-unprovoked-venous-thromboembolism
#14
Clive Kearon, Sameer Parpia, Frederick A Spencer, Trevor Baglin, Scott M Stevens, Kenneth A Bauer, Steven R Lentz, Craig M Kessler, James D Douketis, Stephan Moll, Scott Kaatz, Sam Schulman, Jean M Connors, Jeffrey S Ginsberg, Luciana Spadafora, Vinai Bhagirath, Patricia C Liaw, Jeffrey I Weitz, Jim A Julian
It is uncertain whether antiphospholipid antibodies (APAs) increase the risk of recurrence after a first unprovoked venous thromboembolism (VTE). We tested for anticardiolipin antibodies, anti-β2 glycoprotein 1 antibodies, and lupus anticoagulant on 2 occasions ∼6 months apart in 307 patients with a first unprovoked VTE who were part of a prospective cohort study. We then determined if APAs were associated with recurrent thrombosis in the 290 patients who stopped anticoagulant therapy in response to negative D-dimer results...
May 10, 2018: Blood
https://www.readbyqxmd.com/read/29485803/extensive-deep-venous-thrombosis-in-a-young-male-patient-as-the-first-manifestation-of-a-rare-venous-anomaly-inferior-vena-cava-duplication-case-report
#15
Dražen Pulanić, Ena Ranković, Marijo Vodanović, Mario Lušić, Ana Boban, Silva Zupančić Šalek, Damir Nemet
Although venous thromboembolism (VTE) including deep venous thrombosis (DVT) and pulmonary embolism is a major health problem in the world, it is an infrequent disease among young people. It is always mandatory to look at the underlying conditions for VTE, and in young patients, inherited prothrombotic factors should also be evaluated, especially in case of unprovoked VTE. Anomalies of inferior vena cava (IVC) are very rare in the general population. In this case report we describe rare occurrence of extensive DVT in a young male patient with rare anomaly of IVC - duplication of IVC - as a predisposition factor for DVT...
June 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29432897/bleeding-predictors-in-patients-following-venous-thromboembolism-treated-with-vitamin-k-antagonists-association-with-increased-number-of-single-nucleotide-polymorphisms
#16
Agata Hanna Bryk, Ewa Wypasek, Krzysztof Plens, Magdalena Awsiuk, Anetta Undas
INTRODUCTION: Single nucleotide polymorphisms (SNP) in genes encoding proteins involved in metabolism and action of vitamin K antagonists (VKA) affect anticoagulation stability. We investigated how those polymorphisms influence bleeding rates in patients following venous thromboembolism (VTE). MATERIALS AND METHODS: In 324 patients following unprovoked VTE, 143 (44%) on warfarin and 181 (56%) on acenocoumarol, we recorded bleeds within the preceding 24 months...
February 9, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29390512/venous-thromboembolism-related-to-cytomegalovirus-infection-a-case-report-and-literature-review
#17
REVIEW
Amar H Kelkar, Kavitha S Jacob, Eman B Yousif, John J Farrell
RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29331940/screening-and-functional-exploration-of-prothrombin-arg596-related-mutations-in-chinese-venous-thromboembolism-patients
#18
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
#19
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
#20
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
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