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Unprovoked VTE

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https://www.readbyqxmd.com/read/27886530/choosing-wisely-the-impact-of-patient-selection-on-efficacy-and-safety-outcomes-in-the-einstein-dvt-pe-and-amplify-trials
#1
Jan Beyer-Westendorf, Anthonie W A Lensing, Roopen Arya, Henri Bounameaux, Alexander T Cohen, Philip S Wells, Saskia Middeldorp, Peter Verhamme, Rodney Hughes, Nils Kucher, Akos F Pap, Mila Trajanovic, Martin H Prins, Paolo Prandoni, Jeffrey I Weitz
BACKGROUND: The results of the EINSTEIN-DVT/PE and AMPLIFY trials, which compared rivaroxaban and apixaban with conventional anticoagulation therapy for acute venous thromboembolism (VTE), respectively, are often compared. However, the trials differed in duration of therapy (3-12 and 6months, respectively) and in patient selection (few exclusion criteria and more stringent exclusion criteria, respectively). METHODS: To determine the effect of these methodological differences on outcomes, the patients enrolled in EINSTEIN-DVT/PE were divided into 2 cohorts; the 5253 patients that matched the exclusion criteria for AMPLIFY and were treated for at least 6months (cohort 1) and the 2368 patients who would have been ineligible for AMPLIFY (cohort 2)...
November 21, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27876590/clinical-prognosis-of-non-massive-central-and-non-central-pulmonary-embolism-a-registry-based-cohort-study
#2
Bobby Gouin, Marc Blondon, David Jiménez, Carmen Fernández-Capitán, Henri Bounameaux, Silvia Soler, Rita Duce, Joan Carles Sahuquillo, Nuria Ruiz-Giménez, Manuel Monreal
BACKGROUND: Whether the localization of non-massive pulmonary embolism (PE) is associated with the short and long-term prognosis of patients remains unknown. Our aim is to characterize associations of non-massive PE localization with risks of recurrent venous thromboembolism (VTE), major bleeding and mortality during and after anticoagulation. METHODS: Among participants of the RIETE registry with an incident symptomatic non-massive PE diagnosed by computerized tomography (CT), we compared risks of recurrent VTE, major bleeding and mortality during and after anticoagulation period between central PE (main pulmonary artery) and non-central PE (more peripheral arteries), using Cox proportional hazard adjusted models...
November 19, 2016: Chest
https://www.readbyqxmd.com/read/27831499/association-of-traditional-cardiovascular-risk-factors-with-venous-thromboembolism-an-individual-participant-data-meta-analysis-of-prospective-studies
#3
Bakhtawar K Mahmoodi, Mary Cushman, Inger Anne Næss, Matthew A Allison, Willem Jan Bos, Sigrid K Brækkan, Suzanne Cannegieter, Ron T Gansevoort, Philimon N Gona, Jens Hammerstrøm, John-Bjarne Hansen, Susan Heckbert, Anders G Holst, Susan G Lakoski, Pamela L Lutsey, JoAnn E Manson, Lisa W Martin, Kunihiro Matsushita, Karina Meijer, Kim Overvad, Eva B Prescott, Marja K Puurunen, Jacques Rossouw, Yingying Sang, Marianne T Severinsen, Jur M Ten Berg, Aaron R Folsom, Neil A Zakai
BACKGROUND: -There is much controversy surrounding the association of traditional cardiovascular disease (CVD) risk factors with venous thromboembolism (VTE). METHODS: - We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline CVD risk factors and validated VTE events. Definitions were harmonized across studies. Traditional CVD risk factors were modeled categorically, as well as continuously using restricted cubic splines...
November 9, 2016: Circulation
https://www.readbyqxmd.com/read/27821402/ischemic-stroke-and-risk-of-venous-thromboembolism-in-the-general-population-the-troms%C3%A3-study
#4
Ludvig B Rinde, Birgit Småbrekke, Ellisiv B Mathiesen, Maja-Lisa Løchen, Inger Njølstad, Erin M Hald, Tom Wilsgaard, Sigrid K Brækkan, John-Bjarne Hansen
BACKGROUND: Even though clinical data support a relation between ischemic stroke and venous thromboembolism (VTE), the strength and time dependence of the association remain to be settled at the population level. We therefore aimed to investigate the association between ischemic stroke and VTE in a prospective population-based cohort. METHODS AND RESULTS: Participants (n=30 002) were recruited from 3 surveys of the Tromsø study (conducted in 1994-1995, 2001, and 2007-2008) and followed through 2010...
November 7, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27815969/residual-pulmonary-vascular-obstruction-and-recurrence-after-acute-pulmonary-embolism-a-single-center-cohort-study
#5
Benjamin Planquette, Alexis Ferré, Julien Peron, Amandine Vial-Dupuy, Jean Pastre, Gisèle Mourin, Joseph Emmerich, Marie-Anne Collignon, Guy Meyer, Olivier Sanchez
INTRODUCTION: Up to 50% of patients with pulmonary embolism (PE) present lung perfusion defects after six months of anticoagulant treatment, suggesting residual pulmonary vascular obstruction (RPVO). The risk of recurrence in patients with RPVO remains unknown. The present study aims to assess the risk of recurrent venous thromboembolism (VTE) in patients with RPVO after a first symptomatic episode of PE. METHODS: Consecutive patients who survived a first objectively proven acute PE, treated for at least three months with anticoagulants, were included and followed prospectively...
October 29, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27812260/red-cell-distribution-width-has-a-predictable-value-for-differentiation-of-provoked-and-unprovoked-venous-thromboembolism
#6
Sehmus Ertop, Muammer Bilici, Huseyin Engin, Cagatay Buyukuysal, Muzeyyen Arslaner, Bilal Toka, Ishak Ozel Tekin
Venous thromboembolism (VTE) is generally classified as provoked or unprovoked. This dichotomy is important for following patients, mortality rate, prognosis and whether more efficient therapy is needed. In VTE patients, during initial diagnosis, it is not known exactly whether red cell distribution width (RDW) have a predictable value for this differentiation and pathogenesis. In this study, 298 patients with VTE and 197 control subjects were included. Patients with VTE were defined as provoked or unprovoked with respect to physical examination findings and laboratory values...
December 2016: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/27771600/deep-venous-thrombosis-as-the-single-sign-of-unexpected-metastatic-urinary-tract-cancer-in-a-patient-with-a-history-of-cutaneous-melanoma-a-case-report
#7
Joachim Mikkelsen, Steen Henrik Matzen
INTRODUCTION: Cancer is a recognized risk factor of venous thromboembolism (VTE) as it induces a prothrombotic state through various mechanisms of activation of coagulation. Recognizing occult cancer as a risk factor is equally important. In patients with no known thromboembolic risk factors, utilizing PET/CT as a screening tool may be considered in order to reveal occult malignancy associated with otherwise unexplainable VTE. METHODS: This case report has been reported in line with the SCARE criteria...
October 14, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27766390/jak2v617f-and-calreticulin-mutations-in-recurrent-venous-thromboembolism-results-from-the-edith-prospective-cohort
#8
Jean-Christophe Ianotto, Aurélie Chauveau, Dominique Mottier, Valérie Ugo, Christian Berthou, Eric Lippert, Aurélien Delluc
Cancer incidence in patients with recurrent unprovoked venous thromboembolism (VTE) is much higher than after a first event, but the incidence of myeloproliferative neoplasms (MPN) in this situation is still unknown. We tested for JAK2V617F and calreticulin mutants, 372 DNA samples of patients treated for (VTR). Among these patients, 10 (2.7%) were carrying JAK2V617F mutation and none of them any of the calreticulin (CALR) mutations. Among the 19 patients who had VTE recurrence under vitamin K antagonists, 4 patients (21...
October 20, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27766052/cancer-associated-thrombosis-in-asia
#9
Pantep Angchaisuksiri
Thrombosis is a common complication in cancer patients. Although the major inherited risk factors for thrombophilia are different between Asians and Caucasians, the main acquired risk factors that are associated with the development of venous thromboembolism (VTE) in Asians appear to be similar to those for Caucasians. Malignancy is the most important acquired risk factor for VTE in Asians. Recent studies have shown that the incidence of VTE is significant in Asian patients with cancer, particularly those in an advanced stage...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27764967/cardiovascular-fitness-in-young-males-and-risk-of-unprovoked-venous-thromboembolism-in-adulthood
#10
Bengt Zöller, Henrik Ohlsson, Jan Sundquist, Kristina Sundquist
BACKGROUND: Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. The present study aims to determine whether high cardiovascular fitness reduces the risk of VTE. METHODS: A Swedish cohort of male conscripts (n = 773925) born in 1954-1970 with no history of previous VTE were followed from enlistment (1972-1990) until 2010. Data on cardiovascular fitness using a cycle ergonometric test (maximal aerobic workload in Watt [Wmax]) at conscription were linked with national hospital register data and the Multi-Generation Register...
October 21, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27764883/epidemiology-of-familial-aggregation-of-venous-thromboembolism
#11
Bengt Zöller, Xinjun Li, Henrik Ohlsson, Jianguang Ji, Ashfaque A Memon, Peter J Svensson, Karolina Palmér, Björn Dahlbäck, Jan Sundquist, Kristina Sundquist
Familial aggregation (clustering) of venous thromboembolism (VTE) is the clustering of VTE within a family. Though several genes, such as antithrombin, protein C, protein S, factor V, and prothrombin are associated with the familial clustering of VTE, these loci only partially explain the familial aggregation of VTE. The epidemiology of the familial aggregation of VTE exhibits typical characteristics of complex traits. The family history of VTE in first-degree relatives is associated with a two to three times increased familial relative risk (FRR)...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27764880/extensive-computed-tomography-versus-limited-screening-for-detection-of-occult-cancer-in-unprovoked-venous-thromboembolism-a-multicenter-controlled-randomized-clinical-trial
#12
Paolo Prandoni, Enrico Bernardi, Fabio Dalla Valle, Adriana Visonà, Pietro F Tropeano, Carlo Bova, Eugenio Bucherini, Md Shahidul Islam, Andrea Piccioli
Patients with unprovoked venous thromboembolism (VTE) may harbor occult cancer. Whether an extensive diagnostic work-up for cancer has additional value over a more limited screening for detection of underlying malignancy in these patients is controversial. We performed a randomized multicenter trial to assess if in patients with unprovoked VTE, a computed tomography (CT)-based diagnostic strategy including thoracic, abdominal, and pelvic CT in combination with fecal occult blood test yields a higher cancer detection rate than a nonstandardized testing approach based on physicians' clinical judgment and patients' preferences...
October 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27740860/management-of-idiopathic-venous-thromboembolism
#13
Benilde Cosmi
Idiopathic or unprovoked venous thromboembolism is an event occurring in the absence of any apparent provoking or triggering environmental risk factors, such as surgery, trauma, and immobilization. Areas covered: Unprovoked VTE can be associated with occult cancer, but only limited, and not extensive cancer screening, may be warranted, as the rate of occult cancer is low in such patients. Routine thrombophilia testing is not currently recommended as it does not influence the management of the disease. The duration of anticoagulation for unprovoked VTE after the first three months is still debated as the disease tends to recur regardless of treatment duration...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27696765/lung-function-respiratory-symptoms-and-venous-thromboembolism-risk-the-atherosclerosis-risk-in-communities-study
#14
Yasuhiko Kubota, Stephanie J London, Mary Cushman, Alanna M Chamberlain, Wayne D Rosamond, Susan R Heckbert, Neil Zakai, Aaron R Folsom
BACKGROUND: The evidence of the association between chronic obstructive pulmonary disease (COPD) and venous thromboembolism (VTE) is limited. There is no study investigating the association of restrictive lung disease (RLD) and respiratory symptoms with VTE. OBJECTIVES: To investigate prospectively the association of lung function and respiratory symptoms with VTE. PATIENTS/METHODS: In 1987-1989, we assessed lung function using spirometry and obtained information on respiratory symptoms (cough, phlegm and dyspnea) in 14 654 participants aged 45-64, without a history of VTE or anticoagulant use, and followed them through 2,011...
October 1, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27696701/the-long-term-recurrence-risk-of-patients-with-unprovoked-venous-thromboembolism-an-observational-cohort-study
#15
P A Kyrle, M Kammer, L Eischer, A Weltermann, E Minar, M Hirschl, G Heinze, S Eichinger
BACKGROUND: The long-term recurrence risk (ltRR) of venous thromboembolism (VTE) is uncertain. Objective to assess the ltRR of patients with first unprovoked VTE. PATIENTS/METHODS: Patients were classified into 3 categories; distal deep-vein thrombosis (DVT), proximal DVT, or pulmonary embolism (PE), i.e. PE associated with DVT or isolated PE. Patients with major thrombophilia or antithrombotic therapy were excluded. End point was recurrent symptomatic VTE. RESULTS: 839 patients were followed for a median of 7...
October 2, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27620306/the-optimal-duration-of-anticoagulation-in-patients-with-unprovoked-venous-thromboembolism
#16
Paolo Prandoni
Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years after a first episode is consistently around 30 %. This risk is higher in patients with unprovoked than in those with (transient) provoked VTE, and among the latter in patients with medical than in those with surgical risk factors. Baseline parameters that have been found to be related to the risk of recurrent VTE are the proximal location of deep vein thrombosis, obesity, old age, male sex and non-0 blood group, whereas the role of inherited thrombophilia is controversial...
September 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27443696/screening-for-malignancy-in-patients-with-unprovoked-venous-thromboembolism-a-single-center-retrospective-case-series
#17
Aisling Barrett, Barry Kevane, Patricia Hall, Fionnuala Ní Áinle, Tomás Breslin
In this prospective review of cancer screening in unselected patients with unprovoked venous thromboembolism (VTE) presenting to a large teaching hospital in the Republic of Ireland, we aimed to determine the effects of the implementation of the National Institute for Health and Care Excellence screening policy in a "real-world" population. Within our institution, 64 individuals presented with unprovoked VTE during the study period, of whom 47 underwent a screening computed tomography (CT) scan. Two cases of previously undiagnosed cancer were identified...
July 21, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27442716/epidemiology-of-venous-thromboembolism-in-the-framingham-heart-study
#18
Marja K Puurunen, Philimon N Gona, Martin G Larson, Joanne M Murabito, Jared W Magnani, Christopher J O'Donnell
BACKGROUND: Reports of the crude incidence of venous thromboembolism (VTE) in Western countries vary widely. Data regarding risk factors, incidence and recurrence of VTE from deeply-phenotyped community-based cohort studies are needed. OBJECTIVES: To study the incidence, associated mortality, and predisposing factors of VTE in the prospective, longitudinal community-based Framingham Heart Study. PATIENTS/METHODS: The study sample consisted of the Framingham Heart Study Original, Offspring, Third Generation, and Omni cohorts (N=9754)...
September 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27423718/comparison-of-pathogenic-mechanisms-underlying-single-and-recurrent-venous-thromboembolism-based-on-gene-expression-profiling
#19
Dejun Xu, Rutao Xu, Liu He, Tao Xu, Zhenyu Zhang, Dongmei Han, Jianshi Du
PURPOSE: Unprovoked venous thromboembolism (VTE) generally divided into single and recurrent categories, is a common leading cause of morbidity and mortality in a real-world population. This study was aim to explore the similarities and differences in the mechanisms of single and recurrent VTE. MATERIAL AND METHODS: Gene expression data (GSE19151) generated from 63 healthy controls, 32 single and 38 recurrent VTE patients were analyzed. Differentially expressed genes (DEGs) were screened by Affy package and Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analysis were performed using database for annotation, visualization, and integrated discovery (DAVID)...
July 13, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27411161/venous-thromboembolism-and-subsequent-permanent-work-related-disability
#20
S K Braekkan, S D Grosse, E M Okoroh, J Tsai, S C Cannegieter, I A Naess, S Krokstad, J-B Hansen, F E Skjeldestad
: Essentials The burden of venous thromboembolism (VTE) related to permanent work-related disability is unknown. In a cohort of 66 005 individuals, the risk of work-related disability after a VTE was assessed. Unprovoked VTE was associated with 52% increased risk of work-related disability. This suggests that indirect costs due to loss of work time may add to the economic burden of VTE. SUMMARY: Background The burden of venous thromboembolism (VTE) related to permanent work-related disability has never been assessed among a general population...
October 2016: Journal of Thrombosis and Haemostasis: JTH
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