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Unprovoked pulmonary embolism

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https://www.readbyqxmd.com/read/29142803/unprovoked-pulmonary-embolism-in-a-young-patient-with-marfan-syndrome
#1
Stella Pak, Andrew Kilgore, Rosanne Thornhill, Kyle Rako, Ali Meier, Gavriella Pora, Jillian M Costello, Christine Dee
Marfan syndrome is a rare connective tissue disorder with a prevalence of approximately 2 to 3 per 10,000 individuals. There have been some reports of young patients with Marfan syndrome developing arteriovenous thromboembolism. These events were unprovoked and recurrent. Owing to its rarity, hypercoagulopathy and other metabolic derangement in patients with Marfan syndrome remains largely unknown. Herein, we report a case of a young man with Marfan syndrome who had myocardial infarction and pulmonary embolism...
September 5, 2017: Curēus
https://www.readbyqxmd.com/read/29076888/role-of-perfusion-defects-at-follow-up-lung-scan-in-predicting-recurrences-after-a-first-episode-of-symptomatic-pulmonary-embolism-a-retrospective-analysis
#2
Liliana Villari, Roberta Pancani, Ferruccio Aquilini, Letizia Marconi, Laura Carrozzi, Antonio Palla, Alessandro Celi
The optimal duration of anticoagulant therapy after a first episode of unprovoked pulmonary thromboembolism is not fully defined. The identification of patients more prone to recurrence would be useful in this context but is currently relatively unreliable. Perfusion lung scan (PLS) is an established approach for the follow-up of patients with pulmonary embolism to identify recurrences and to help in the diagnosis of chronic thromboembolic pulmonary hypertension. The aim of the study was to investigate the potential role of residual perfusion defects at follow-up perfusion scans in predicting pulmonary embolism recurrences...
October 25, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29027082/factors-associating-with-the-presence-of-residual-thrombosis-after-3-month-treatment-of-acute-pulmonary-embolism
#3
Jingluan Wang, Mingling Xu, Nina Sun, Zhaozhong Cheng, Jingjing Sui
The present study aimed to investigate the factors associating with the presence of residual thrombosis in patients with acute pulmonary embolism (APE) after at least 3-month anticoagulant therapy. Demographic and clinical data of 180 cases in the affiliated hospital of Qingdao University from January 2005 to June 2015 were retrospectively analyzed. APE in all patients were confirmed by computed tomography pulmonary angiography (CTPA). Patients were then detected for the presence of residual thrombosis according to a second CTPA...
October 12, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28925904/factors-associated-with-pulmonary-embolism-recurrence-and-the-benefits-of-long-term-anticoagulant-therapy
#4
Javier Anniccherico, Jose-Luis Alonso-Martinez, Mirem Urbieta, Jorge Rojo Alvaro, Ione Villar-Garcia
BACKGROUND: Venous thromboemboli tend to recur. However, the causative factors underlying pulmonary embolism recurrence are not well defined. AIMS: To explore the factors associated with pulmonary embolism recurrence. PATIENTS AND METHODS: Patients diagnosed with pulmonary emboli between 2004 and 2013 at our institution were enrolled. Duration of anticoagulant therapy, new episodes of venous thromboembolism, and deaths were recorded. RESULTS: Pulmonary embolism was diagnosed in 528 patients (median age: 76 years, interquartile range [IQR]: 16; male: 45%)...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28853209/inferior-vena-cava-atresia-predisposing-to-acute-lower-extremity-deep-vein-thrombosis-in-children-a-descriptive-dual-center-study
#5
Cristina Tarango, Riten Kumar, Manish Patel, Anne Blackmore, Patrick Warren, Joseph S Palumbo
PURPOSE: Thrombosis in the healthy pediatric population is a rare occurrence. Little is known about the optimal treatment or outcomes of children with unprovoked acute lower extremity (LE) deep vein thrombosis (DVT) associated with atresia of the inferior vena cava (IVC). METHODS: We retrospectively analyzed the records of patients with acute LE DVT subsequently found to have IVC atresia who presented to two tertiary pediatric institutions between 2008 and 2016...
August 29, 2017: Pediatric Blood & Cancer
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
#6
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/28780342/e-selectin-and-sicam-1-biomarkers-of-endothelial-function-predict-recurrence-of-venous-thromboembolism
#7
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/28756076/-anticoagulation-after-an-acute-pulmonary-embolism
#8
Raphael Le Mao, Cécile Tromeur, Francis Couturaud
In order to determine the optimal duration of anticoagulation after an acute pulmonary embolism, the benefit risk balance needs to be analysed based on the risk of recurrent venous thromboembolism in the absence of anticoagulation and the risk of bleeding while on anticoagulant therapy. Such evaluation take in account the frequency and the severity of the risks; clinical variables appear more informative to predict recurrent venous thromboembolism than biochemical or morphological variables. Three major results are now available: (1) the minimal duration of anticoagulation for pulmonary embolism is 3 months; (2) after pulmonary embolism that was provoked by a major transient risk factor, the risk of recurrence is low and does not justify to prolong anticoagulation beyond 6 months; and (3), in patients with an unprovoked pulmonary embolism (high risk of recurrence), the prolongation of anticoagulation up to 1 or 2 years as compared to 3 or 6 months is not associated with a long term reduction in the risk of recurrence and, consequently, these patients should be treated either during 3 to 6 months or indefinitely...
July 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#9
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/28680172/direct-oral-anticoagulants-and-vitamin-k-antagonists-for-treatment-of-deep-venous-thrombosis-and-pulmonary-embolism-in-the-outpatient-setting-comparative-economic-evaluation
#10
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/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#11
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/28546279/impact-of-residual-pulmonary-obstruction-on-the-long-term-outcome-of-patients-with-pulmonary-embolism
#12
Raffaele Pesavento, Lucia Filippi, Antonio Palla, Adriana Visonà, Carlo Bova, Marco Marzolo, Fernando Porro, Sabina Villalta, Maurizio Ciammaichella, Eugenio Bucherini, Giovanni Nante, Sandra Battistelli, Maria Lorenza Muiesan, Giampietro Beltramello, Domenico Prisco, Franco Casazza, Walter Ageno, Gualtiero Palareti, Roberto Quintavalla, Simonetta Monti, Nicola Mumoli, Nello Zanatta, Roberto Cappelli, Marco Cattaneo, Valentino Moretti, Francesco Corà, Mario Bazzan, Angelo Ghirarduzzi, Anna Chiara Frigo, Massimo Miniati, Paolo Prandoni
The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28522384/usefulness-of-d-dimer-testing-in-predicting-recurrence-in-elderly-patients-with-unprovoked-venous-thromboembolism
#13
MULTICENTER STUDY
Tobias Tritschler, Andreas Limacher, Marie Méan, Nicolas Rodondi, Drahomir Aujesky
BACKGROUND: Whether post-anticoagulation D-dimer levels are useful in predicting recurrence in elderly patients with unprovoked venous thromboembolism is unknown. METHODS: We followed up 157 patients aged ≥65 years with acute symptomatic, unprovoked venous thromboembolism in a prospective, multicenter cohort study. All patients completed 3-12 months of anticoagulation and then underwent quantitative D-dimer testing (enzyme-linked immunosorbent assay) 12 months after the index venous thromboembolism...
October 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28469497/performing-anticoagulation-a-puzzling-case-of-cholesterol-embolization-syndrome
#14
Yusuke Igarashi, Tetsu Akimoto, Takahisa Kobayashi, Yoshitaka Iwazu, Takuya Miki, Naoko Otani-Takei, Toshimi Imai, Taro Sugase, Takahiro Masuda, Shin-Ichi Takeda, Shigeaki Muto, Daisuke Nagata
The avoidance of any form of anticoagulation is advised in cases of cholesterol embolization syndrome (CES). We herein describe a case of CES in a man with a history of unprovoked pulmonary embolism for which warfarinization was performed. Despite anecdotal reports of successful anticoagulation in CES patients with certain indications, irreversible renal failure, which was sufficiently severe to require chronic hemodialysis, eventually developed in our patient. Our results emphasize the pitfalls of this procedure, which imply its limited feasibility and safety...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28447414/review-of-d-dimer-testing-good-bad-and-ugly
#15
REVIEW
L-A Linkins, S Takach Lapner
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28440013/sex-specific-differences-in-the-presenting-location-of-a-first-venous-thromboembolism
#16
L J J Scheres, M P A Brekelmans, L F M Beenen, H R Büller, S C Cannegieter, S Middeldorp
Essentials Whether the location of venous thromboembolism (VTE) differs between the sexes is not known. Pulmonary embolism as presenting location was relatively more common in women than in men. The difference was consistent among age groups and most prominent in unprovoked VTE. The underlying mechanism remains to be elucidated. SUMMARY: Background The risk of venous thromboembolism (VTE) differs between men and women. Some risk factors seem to influence the presenting location of VTE...
July 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28439955/recurrent-venous-thrombosis-related-to-overweight-and-obesity-results-from-the-mega-follow-up-study
#17
B A Vučković, S C Cannegieter, A van Hylckama Vlieg, F R Rosendaal, W M Lijfering
Essentials Whether excess body weight influences recurrent venous thrombosis (VT) risk is uncertain. We included 3889 VT patients, classified into body mass index (BMI) strata to estimate recurrent VT risk. No evidence of an increased risk for excess body weight was found. Measuring BMI is not a good tool to identify patients at high risk of VT recurrence. SUMMARY: Background Studies on the risk of recurrent venous thrombosis in patients with excess body weight have yielded conflicting results...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28439954/survival-and-recurrent-venous-thromboembolism-in-patients-with-first-proximal-or-isolated-distal-deep-vein-thrombosis-and-no-pulmonary-embolism
#18
S Barco, M Corti, A Trinchero, C Picchi, C Ambaglio, S V Konstantinides, F Dentali, M Barone
Essentials The long-term risk of recurrence and death after distal deep vein thrombosis (DVT) is uncertain. We included subjects with first proximal or isolated distal DVT (IDDVT) and no pulmonary embolism. The risk of symptomatic and asymptomatic recurrence is lower after IDDVT (vs. proximal). IDDVT may be associated with a lower long-term risk of death, especially after unprovoked DVT. SUMMARY: Background A few studies have focused on the risk of recurrence after first acute isolated distal deep vein thrombosis (IDDVT) compared with proximal DVT (PDVT), whereas the incremental risk of death has never been explored beyond the first 3 years after acute event...
July 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28411120/effectiveness-and-safety-of-rivaroxaban-and-warfarin-in-patients-with-unprovoked-venous-thromboembolism-a-propensity-matched-nationwide-cohort-study
#19
Torben B Larsen, Flemming Skjøth, Jette N Kjældgaard, Gregory Y H Lip, Peter B Nielsen, Mette Søgaard
BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism are collectively known as venous thromboembolism (VTE), which is a common vascular disease and a major cause of morbidity and mortality worldwide. We compare effectiveness and safety of rivaroxaban versus warfarin in a prospective cohort of routine care patients with incident unprovoked VTE. METHODS: In this propensity-matched cohort study, we linked nationwide Danish health registries to identify all patients with a first hospital diagnosis of unprovoked VTE who were new users of rivaroxaban or warfarin...
May 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28314711/validating-the-herdoo2-rule-to-guide-treatment-duration-for-women-with-unprovoked-venous-thrombosis-multinational-prospective-cohort-management-study
#20
MULTICENTER STUDY
Marc A Rodger, Gregoire Le Gal, David R Anderson, Jeannot Schmidt, Gilles Pernod, Susan R Kahn, Marc Righini, Patrick Mismetti, Clive Kearon, Guy Meyer, Antoine Elias, Tim Ramsay, Thomas L Ortel, Menno V Huisman, Michael J Kovacs
Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants...
March 17, 2017: BMJ: British Medical Journal
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