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Unprovoked pulmonary embolism

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https://www.readbyqxmd.com/read/28208204/thrombophilic-evaluation-in-patients-with-acute-pulmonary-embolism
#1
Scott M Stevens, Jack E Ansell
Patients with acute pulmonary embolism (PE) are often tested for thrombophilias, which are hereditary and acquired conditions that predispose to thrombosis. If a hereditary condition is identified, then testing is often performed on members of the patient's family. Testing for these conditions can be complex, as the presence of acute thrombosis and antithrombotic therapies can make the results of many tests unreliable. Many risk factors for thrombosis exist that are not routinely assessed by laboratory testing, and it is likely that many hereditary thrombophilia conditions remain to be discovered...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208203/acute-pulmonary-embolism-after-discharge-duration-of-therapy-and-follow-up-testing
#2
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/28183418/clinical-characteristics-of-coexisting-pulmonary-thromboembolism-in-patients-with-respiratory-tuberculosis
#3
Hyeyoung Park, Seung-Ick Cha, Jae-Kwang Lim, Kyung Nyeo Jeon, Seung-Soo Yoo, Jaehee Lee, Shin-Yup Lee, Chang-Ho Kim, Jae-Yong Park
OBJECTIVES: Data regarding coexisting pulmonary thromboembolism (PTE) in patients with tuberculosis are limited. The aim of this study was to investigate the clinical features of coexisting PTE in patients with respiratory tuberculosis. METHODS: Clinical parameters were retrospectively compared between the tuberculosis group (PTE and coexisting respiratory tuberculosis) and unprovoked or provoked group selected from a single institution in South Korea, a country that has an intermediate tuberculosis burden...
February 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28174134/whole-exome-sequencing-reveals-severe-thrombophilia-in-acute-unprovoked-idiopathic-fatal-pulmonary-embolism
#4
Matt Halvorsen, Ying Lin, Barbara A Sampson, Dawei Wang, Bo Zhou, Lucy S Eng, Sung Yon Um, Orrin Devinsky, David B Goldstein, Yingying Tang
BACKGROUND: Acute unprovoked idiopathic fatal pulmonary embolism (IFPE) causes sudden death without an identifiable thrombogenic risk. We aimed to investigate the underlying genomic risks of IFPE through whole exome sequencing (WES). METHODS: We reviewed 14years of consecutive out-of-hospital fatal pulmonary embolism records (n=1478) from the ethnically diverse population of New York City. We selected 68 qualifying IFPE cases for WES. We compared the WES data of IFPE cases to those of 9332 controls to determine if there is an excess of rare damaging variants in the genome using ethnicity-matched controls in collapsing analyses...
January 31, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28150371/venous-thromboembolism-management-practices-and-knowledge-of-guidelines-a-survey-of-australian-haematologists-and-respiratory-physicians
#5
Rory Wallace, Mary-Ann Anderson, Katharine See, Ms Alexandra Gorelik, A/Prof Louis Irving, Renee Manser
BACKGROUND: Current international clinical practice guidelines do not adequately address all clinical scenarios in the management of venous thromboembolism (VTE) and no comprehensive Australian guidelines exist. We aimed to identify areas of uncertainty in VTE management and whether self-reported practice is consistent with guidelines. METHODS: We conducted an Australian cross-sectional online survey consisting of 53 questions to investigate doctors' VTE management practices...
February 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28135040/lipid-levels-and-risk-of-recurrent-venous-thrombosis-results-from-the-mega-follow-up-study
#6
V M Morelli, W M Lijfering, F R Rosendaal, S C Cannegieter
BACKGROUND: Knowledge of risk factors for recurrent venous thrombosis may guide decisions on duration of anticoagulation. The association between lipid levels and first venous thrombosis has been studied extensively. However, data on the role of lipids in the risk of recurrence are scarce. OBJECTIVE: To assess the association between lipid levels and recurrent venous thrombosis. PATIENTS/METHODS: Patients with a first venous thrombosis were included from the MEGA study...
January 30, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28062504/prothrombotic-fibrin-clot-phenotype-is-associated-with-recurrent-pulmonary-embolism-after-discontinuation-of-anticoagulant-therapy
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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