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Unprovoked pulmonary embolism

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https://www.readbyqxmd.com/read/28062504/prothrombotic-fibrin-clot-phenotype-is-associated-with-recurrent-pulmonary-embolism-after-discontinuation-of-anticoagulant-therapy
#1
Michal Zabczyk, Krzysztof Plens, Wioletta Wojtowicz, Anetta Undas
OBJECTIVE: Pulmonary embolism (PE) is a life-threatening manifestation of venous thromboembolism with a high recurrence rate after anticoagulation cessation. Recently, we have reported that prothrombotic clot phenotype in venous thromboembolism patients is associated with an increased risk of recurrent deep-vein thrombosis. APPROACH AND RESULTS: We tested whether abnormal clot properties are predictive of recurrent PE. We investigated 156 consecutive white patients aged 18 to 65 years after the first-ever provoked or unprovoked PE (n=89), with or without deep-vein thrombosis...
December 29, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27898350/cronkhite-canada-syndrome-complicated-by-pulmonary-embolism-a-case-report
#2
Neha L Nemade, Urvi B Shukla, Gajanan D Wagholikar
INTRODUCTION: Cronkhite Canada Syndrome (CCS) is a rare syndrome, described in 1955 by Americans, Leonard Wolsey Cronkhite and Wilma Jeanne Canada in the New England Journal of Medicine [1]. About 450 cases have been reported. Complications, like malignant transformation, unprovoked thromboembolism is known. Since there is wide variability in medical presentation, no definitive diagnostic and treatment protocol s have been set. The mortality remains at 55%. CASE PRESENTATION: We report a case of a 50 year old male patient presenting with diarrhea, weight loss, abdominal pain, ectodermal features...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27876590/clinical-prognosis-of-non-massive-central-and-non-central-pulmonary-embolism-a-registry-based-cohort-study
#3
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
#4
Bakhtawar K Mahmoodi, Mary Cushman, Inger Anne Næss, Matthew A Allison, Willem Jan Bos, Sigrid K Brækkan, Suzanne C 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 Prescott, Marja Puurunen, Jacques E Rossouw, Yingying Sang, Marianne T Severinsen, Jur Ten Berg, Aaron R Folsom, Neil A Zakai
BACKGROUND: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). METHODS: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines...
January 3, 2017: Circulation
https://www.readbyqxmd.com/read/27821402/ischemic-stroke-and-risk-of-venous-thromboembolism-in-the-general-population-the-troms%C3%A3-study
#5
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
#6
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...
December 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27792638/shorter-hospital-stays-and-lower-costs-for-rivaroxaban-compared-with-warfarin-for-venous-thrombosis-admissions
#7
Jay M Margolis, Steven Deitelzweig, Jeffrey Kline, Oth Tran, David M Smith, Brahim Bookhart, Concetta Crivera, Jeff Schein
BACKGROUND: Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, results in a substantial healthcare system burden. This retrospective observational study compared hospital length of stay (LOS) and hospitalization costs for patients with venous thromboembolism treated with rivaroxaban versus those treated with warfarin. METHODS AND RESULTS: Hospitalizations for adult patients with a primary diagnosis of deep vein thrombosis or pulmonary embolism who were initiated on rivaroxaban or warfarin were selected from MarketScan's Hospital Drug Database between November 1, 2012, and December 31, 2013...
October 6, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27766050/causes-of-venous-thrombosis
#8
REVIEW
F R Rosendaal
Venous thrombosis which mainly manifests as deep vein thrombosis of the leg or pulmonary embolism occurs in 1 per 1000 per year. It occurs due to interacting genetic, environmental and behavioral risk factors. The strongest risk factors are certain types of surgery and malignancies. Over the last decade many new risk factors for venous thrombosis have been identified. Venous thrombosis has a high recurrence rate, of around 5 % per year. Whereas clinically it would be most important to identify patients at risk of recurrence, only male sex and a previous unprovoked thrombosis are established determinants of recurrent thrombosis...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27764881/update-on-the-treatment-of-venous-thromboembolism
#9
Sam Schulman
During the past 7 years, results from phase III trials comparing nonvitamin antagonist K oral anticoagulants (NOACs) with vitamin K antagonists (VKAs) or with placebo, including 34,900 patients, have been published. Recent guidelines have been updated and now suggest treatment with NOACs rather than with VKA. Other updates in the guidelines concern the initial thrombolytic treatment for selected patients with deep vein thrombosis or pulmonary embolism as well as the possibility of withholding anticoagulation for minimal venous thromboembolism...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27751675/pulmonary-embolism-inpatients-treated-with-rivaroxaban-had-shorter-hospital-stays-and-lower-costs-compared-with-warfarin
#10
Jay M Margolis, Steven Deitelzweig, Jeffrey Kline, Oth Tran, David M Smith, Concetta Crivera, Brahim Bookhart, Jeff Schein
PURPOSE: Using real-world data, this study compares inpatient length of stay (LOS) and costs for patients with a primary diagnosis of pulmonary embolism (PE) initiating treatment with oral anticoagulation with rivaroxaban versus warfarin. METHODS: Hospitalizations from MarketScan's Hospital Drug Database were selected from November 1, 2012, through December 31, 2013, for adults with a primary diagnosis of PE initiating treatment with rivaroxaban or warfarin. Warfarin patients were matched 1:1 to rivaroxaban patients using exact and propensity score matching...
November 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27696765/lung-function-respiratory-symptoms-and-venous-thromboembolism-risk-the-atherosclerosis-risk-in-communities-study
#11
Y Kubota, S J London, M Cushman, A M Chamberlain, W D Rosamond, S R Heckbert, N Zakai, A R Folsom
: Essentials The association of lung function with venous thromboembolism (VTE) is unclear. Chronic obstructive pulmonary disease (COPD) patterns were associated with a higher risk of VTE. Symptoms were also associated with a higher risk of VTE, but a restrictive pattern was not. COPD may increase the risk of VTE and respiratory symptoms may be a novel risk marker for VTE. SUMMARY: Background The evidence for the association between chronic obstructive pulmonary disease (COPD) and venous thromboembolism (VTE) is limited...
December 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
#12
P A Kyrle, M Kammer, L Eischer, A Weltermann, E Minar, M Hirschl, G Heinze, S Eichinger
: Essentials Long-term recurrence risk of venous thromboembolism (VTE) is uncertain. We performed a prospective cohort study of 839 patients with first unprovoked VTE. VTE recurrence risk is high, particularly in men with proximal thrombosis or pulmonary embolism. Sex and VTE site determine the recurrence risk and should be considered for patient counseling. SUMMARY: Background The long-term recurrence risk (ltRR) of venous thromboembolism (VTE) is uncertain. Objective To assess the ltRR of patients with first unprovoked VTE...
December 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27559946/five-year-follow-up-of-pulmonary-embolism-under-anticoaugulation-the-pisa-peet-pulmonary-embolism-extension-therapy-study
#13
Letizia Marconi, Laura Carrozzi, Ferruccio Aquilini, Alessandro Celi, Francesco Pistelli, Antonio Palla
Benefits and harms of long-term anticoagulant therapy (AT) after acute pulmonary embolism (PE) are poorly known. The aim of this study was to investigate the outcome of patients with PE treated with AT for 5 years according to American College of Chest Physicians (ACCP) guidelines.Patients with both unprovoked and secondary PE were consecutively enrolled in a "real life" study. After a 12-month AT, they continued or stopped the treatment according to ACCP guidelines, and were followed-up for 5 years. Outcomes were all-cause mortality, recurrence, and fatal recurrence under AT...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27442716/epidemiology-of-venous-thromboembolism-in-the-framingham-heart-study
#14
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/27375038/deep-vein-thrombosis-and-pulmonary-embolism
#15
REVIEW
Marcello Di Nisio, Nick van Es, Harry R Büller
Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer testing. Imaging and anticoagulation can be safely withheld in patients who are unlikely to have venous thromboembolism and have a normal D-dimer. All other patients should undergo ultrasonography in case of suspected deep vein thrombosis and CT in case of suspected pulmonary embolism...
December 17, 2017: Lancet
https://www.readbyqxmd.com/read/27350751/elevated-risk-of-venous-thromboembolic-events-in-patients-with-inflammatory-myopathies
#16
REVIEW
Michał Nowak, Katarzyna Królak-Nowak, Aleksandra Sobolewska-Włodarczyk, Jakub Fichna, Marcin Włodarczyk
Venous thromboembolism (VTE) is a multifactorial disease manifesting as either deep vein thrombosis or pulmonary embolism. Its prevalence makes VTE a significant issue for both the individual - as a negative factor influencing the quality of life and prognosis - and the society due to economic burden. VTE is the third most common vascular disorder in Western countries, after myocardial infarction and stroke, making it a major cause of in-hospital mortality, responsible for 5%-10% of hospital deaths. Despite many studies conducted, only 50%-60% provoking factors have been identified, while the remaining 40%-50% have been classified as idiopathic or unprovoked...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27336690/impact-of-asymptomatic-pulmonary-embolism-on-the-long-term-prognosis-of-patients-with-deep-venous-thrombosis
#17
Anja Boc, Nina Vene, Katarina Košmelj, Alenka Mavri
Asymptomatic pulmonary embolism (PE) is present in at least one-third of patients with deep venous thrombosis (DVT). However, knowledge about its influence on the prognosis of patients is limited. The aim of this study was to assess the prognostic impact of asymptomatic PE in patients with DVT and to explore risk factors for recurrent venous thromboembolic events. A total of 200 consecutive patients with the first episode of objectively confirmed DVT without symptoms of PE were included. All patients underwent ventilation-perfusion scintigraphy within 48 hours of DVT confirmation...
June 23, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27268941/an-algorithmic-approach-to-management-of-venous-thromboembolism
#18
Prajwal Dhakal, Krishna Gundabolu, Vijaya R Bhatt
Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Factors such as the presence of transient risk factors for VTE, risk of bleeding, and location of deep vein thrombosis (DVT) determine the duration of anticoagulation. Extended anticoagulation is offered to patients with unprovoked pulmonary embolism (PE) or proximal DVT and a low risk of bleeding. Anticoagulation for 3 months is advised in patients with provoked DVT or PE, high risk of bleeding, and isolated distal or upper extremity DVT...
June 5, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27250719/managing-extended-oral-anticoagulation-after-unprovoked-venous-thromboembolism
#19
Lee Joseph, John R Bartholomew
Venous thromboembolism (VTE), which includes deep venous thrombosis and pulmonary embolism, is a major public health problem associated with increased morbidity and mortality. Despite the high recurrence risk associated with unprovoked VTE, extended anticoagulation remains controversial. Oral antithrombotic agents for extended VTE treatment comprise the vitamin K antagonists, aspirin, and the direct oral anticoagulants (also known as target-specific oral anticoagulants and formerly known as the new or novel oral anticoagulants) including rivaroxaban, dabigatran, apixaban, and edoxaban...
May 31, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27206642/dehydration-as-a-possible-cause-of-monthly-variation-in-the-incidence-of-venous-thromboembolism
#20
Saad Elias, Ron Hoffman, Gleb Saharov, Benjamin Brenner, Yona Nadir
BACKGROUND: Monthly or seasonal changes in the incidence of venous thromboembolism (VTE) were previously reported; however, the mechanism of such variability is not completely understood. METHODS: In the present retrospective single-center analysis, consecutive patients with proximal deep vein thrombosis and/or pulmonary embolism (PE) diagnosed between January 2009 and December 2013 were evaluated. RESULTS: The study population included 1496 patients, 48% men, mean age 63 ± 18 years...
September 2016: Clinical and Applied Thrombosis/hemostasis
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