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Venous thromboembolism

Gjam Boon, L F van Dam, F A Klok, M V Huisman
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most frequent cardiovascular disease besides myocardial infarction and stroke. Since DVT may cause life-threatening conditions, treatment should be started as soon as possible. This comprises certain challenges in special populations. Areas covered: In cancer-associated VTE, current treatment is different from non-cancer VTE due to disease-related interventions and higher bleeding risks. In treatment of patients with extensive DVT, the role of catheter-directed thrombolysis has been investigated in two randomised trials but results do not yield a recommendation for standard thrombolysis...
July 17, 2018: Expert Review of Hematology
Miquel Vázquez-Santiago, Noelia Vilalta, Biel Cuevas, Joaquim Murillo, Dolors Llobet, Raquel Macho, Núria Pujol-Moix, Marina Carrasco, José Mateo, Jordi Fontcuberta, José Manuel Soria, Juan Carlos Souto
INTRODUCTION: Platelets play a role in the pathophysiology of venous thromboembolism (VTE). Some studies have not found an association between VTE and platelet aggregation. The PFA-100® analyser is an in vitro assay for assessing primary haemostasis. But, there are no studies to evaluate its association with VTE. We investigated the contribution of the global platelet function and aggregation in the development of VTE. MATERIAL AND METHODS: We analysed 800 individuals who were included in the RETROVE Study (Riesgo de Enfermedad TROmboembólica VEnosa)...
July 11, 2018: Thrombosis Research
Ina Isabella Høiland, Robin Amanda Liang, Kristian Hindberg, Nadezhda Latysheva, Ole-Lars Brekke, Tom Eirik Mollnes, John-Bjarne Hansen
INTRODUCTION: Deep vein thrombosis (DVT) originates in the valvular sinuses of large veins in a local milieu characterized by stasis and severe hypoxia. This may induce complement- and coagulation activation, which potentially increases the risk of venous thromboembolism (VTE). The aim of the present study was to investigate whether the activity of the complement pathways, the level of mannose-binding lectin (MBL) and tissue-factor (TF) induced thrombin generation were associated with risk of unprovoked VTE...
June 30, 2018: Thrombosis Research
Marcello Di Nisio, Matteo Candeloro, Anne Wilhelmina Saskia Rutjes, Valerio Galli, Marcello Tritto, Ettore Porreca
BACKGROUND: Cancer patients hospitalized for an acute medical illness are considered to be at high risk of venous thromboembolism (VTE). Information on bleeding and symptomatic VTE in these patients remains scant. The objectives of this study were to evaluate the incidence of bleeding and VTE during hospitalization and after discharge in a prospective cohort of hospitalized medically-ill cancer patients. METHODS: Consecutive patients with active cancer admitted for an acute medical illness...
July 6, 2018: Thrombosis Research
Kay T Htun, Mabel J Y Ma, Agnes Y Y Lee
Patients with acute leukemia frequently develop catheter-related thrombosis (CRT) despite concurrent thrombocytopenia. The incidence, treatment and outcomes of this complication are poorly documented. We undertook this study to determine the incidence of CRT in patients with acute leukemia and assess the safety and effectiveness of a treatment strategy using a platelet-adjusted low molecular weight heparin (LMWH) dosing protocol. Patients (18 years and older) with newly diagnosed acute leukemia from January 2014 to December 2015 who received central venous catheters were included...
July 16, 2018: Journal of Thrombosis and Thrombolysis
Masao Iwagami, Ben Caplin, Liam Smeeth, Laurie A Tomlinson, Dorothea Nitsch
BACKGROUND: Although chronic kidney disease (CKD) is associated with various outcomes, the burden of each condition for hospital admission is unknown. AIM: To quantify the association between CKD and cause-specific hospitalisation. DESIGN AND SETTING: A matched cohort study in primary care using Clinical Practice Research Datalink linked to Hospital Episode Statistics in England. METHOD: Patients with CKD (estimated glomerular filtration rate <60 mL/min/1...
July 16, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Dale Ding, Padmini Sekar, Charles J Moomaw, Mary E Comeau, Michael L James, Fernando Testai, Matthew L Flaherty, Anastasia Vashkevich, Bradford B Worrall, Daniel Woo, Jennifer Osborne
BACKGROUND: Patients with spontaneous intracerebral hemorrhage (ICH) are predisposed to venous thromboembolic (VTE) complications, such as deep vein thrombosis and pulmonary embolism. OBJECTIVE: To evaluate, in a multicenter, retrospective cohort study, the rate of VTE complications in ICH patients during acute hospitalization, identify potential risk factors, and assess their association with functional outcome. METHODS: We retrospectively analyzed prospectively collected data from 19 centers and 41 sites that participated in the Ethnic/Racial Variations of Intracerebral Hemorrhage study, from August 2010 to February 2016...
July 13, 2018: Neurosurgery
Beatrix Hyemin Choi, Michael Koeckert, Sandra Tomita
There is increasing use of low-molecular-weight heparin (LMWH) for treatment of pediatric thromboembolic disease as it has been shown to be safe and effective. It has several advantages over unfractionated heparin, such as reduced need for monitoring, easier route of administration, decreased risk of heparin-induced thrombocytopenia, and lack of drug-drug interactions. Nevertheless, LMWH still poses a bleeding risk as with any anticoagulant therapy. We present the case of a 4-year-old boy who was placed on LMWH for a catheter-related deep venous thrombosis in the setting of intractable seizures and subsequently developed a small bowel obstruction secondary to a suspected intussusception...
2018: Case Reports in Pediatrics
Jan Beyer-Westendorf, Rupert Bauersachs, Viola Hach-Wunderle, Rainer B Zotz, Hannelore Rott
The use of sex hormones such as combined oral contraceptives (COC) or hormone replacement therapy (HRT) increases the risk for venous thromboembolism (VTE) considerably, especially in patients with an increased intrinsic risk for thromboembolic complications. Despite public and media attention and increasing scientific evidence, prescription patterns seem to be hard to change. It is well recognized that the patient's baseline risk is the most relevant factor in the absolute risk for developing VTE. The relative risk increase associated with sex hormones, depends on the type and dosage of hormones, the route of application (oral, vaginal, transdermal), and for COC, on the specific combination of oestrogen and gestagen components...
July 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Aaron R Folsom, Pamela L Lutsey, Susan R Heckbert, Kripa Poudel, Saonli Basu, Ron C Hoogeveen, Mary Cushman, Christie M Ballantyne
BACKGROUND: We previously showed that participants in the population-based Atherosclerosis Risk in Communities (ARIC) cohort with elevated blood biomarkers of inflammation or cardiac disease were at increased risk of venous thromboembolism (VTE). OBJECTIVE: We hypothesized now that ARIC participants with larger 6-year increases in three biomarkers - C-reactive protein (CRP), N-terminal pro B-type natriuretic peptide (NT-proBNP), and troponin T - also would have increased subsequent risk of VTE...
July 14, 2018: Journal of Thrombosis and Haemostasis: JTH
Ann M Borzecki, Qi Chen, William O'Brien, Michael Shwartz, Peter A Najjar, Kamal M F Itani, Amy K Rosen
BACKGROUND: Studies disagree whether surveillance bias is associated with perioperative venous thromboembolism (VTE) performance measures. A prior VA study used a chart-based outcome; no studies have used the fully specified administrative data-based AHRQ Patient Safety Indicator, PSI-12, as their primary outcome. If surveillance bias were present, we hypothesized that inpatient surveillance rates would be associated with higher PSI-12 rates, but with lower post-discharge VTE rates. METHODS: Using VA data, we examined Pearson correlations between hospital-level VTE imaging rates and risk-adjusted PSI-12 rates and post-discharge VTE rates...
July 4, 2018: American Journal of Surgery
Jerry T Dang, Noah Switzer, Megan Delisle, Michael Laffin, Richdeep Gill, Daniel W Birch, Shahzeer Karmali
BACKGROUND: Bariatric surgery is an effective treatment for severe obesity; however, postoperative venous thromboembolism (VTE) remains a leading cause of morbidity and mortality. The objective of this study is to develop a tool to stratify individuals undergoing laparoscopic bariatric surgery according to their 30-day VTE risk. METHODS: This is a retrospective cohort study of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database...
July 12, 2018: Surgical Endoscopy
Vittorio Pengo, Gentian Denas, Giacomo Zoppellaro, Seena Padayattil Jose, Ariela Hoxha, Amelia Ruffatti, Laura Andreoli, Angela Tincani, Caterina Cenci, Domenico Prisco, Tiziana Fierro, Paolo Gresele, Arturo Cafolla, Valeria De Micheli, Angelo Ghirarduzzi, Alberto Tosetto, Anna Falanga, Ida Martinelli, Sophie Testa, Doris Barcellona, Maria Gerosa, Alessandra Banzato
Rivaroxaban is an effective and safe alternative to warfarin in patients with atrial fibrillation and venous thromboembolism. We tested the efficacy and safety of rivaroxaban as compared to warfarin in high-risk patients with thrombotic Antiphospholipid Syndrome. This is a randomized, open-label, multicenter, non-inferiority study with blinded end-point adjudication. Rivaroxaban 20 mg once daily (15 mg once daily based on kidney function) was compared to warfarin (INR target 2.5), for the prevention of thromboembolic events, major bleeding and vascular death in patients with Antiphospholipid Syndrome...
July 12, 2018: Blood
S R Quadery, A J Swift, C Billings, Aar Thompson, C A Elliot, J Hurdman, A Charalampopoulos, I Sabroe, I Armstrong, N Hamilton, P Sephton, S Garrod, J Pepke-Zaba, D P Jenkins, N Screaton, A M Rothman, A Lawrie, T Cleveland, S Thomas, S Rajaram, C Hill, C Davies, C S Johns, J M Wild, R Condliffe, D G Kiely
BACKGROUND: Pulmonary endarterectomy (PEA) is the gold standard treatment for operable chronic thromboembolic pulmonary hypertension (CTEPH). However, a proportion of patients with operable disease decline surgery. There are currently no published data on this patient group. The aim of this study was to identify outcomes and prognostic factors in a large cohort of consecutive patients with CTEPH. METHODS: Data were collected for consecutive, treatment-naïve CTEPH patients between 2001-2014 identified from the ASPIRE registry...
July 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Setor K Kunutsor, Samuel Seidu, Kamlesh Khunti
PURPOSE: Evidence on the association between depression, antidepressant use and venous thromboembolism (VTE) risk is conflicting. We conducted a systematic review and meta-analysis of published observational studies evaluating the associations of depression and antidepressant use with VTE risk. DESIGN: Eligible studies were identified in a literature search of MEDLINE, Embase, Web of Science and reference list of relevant studies up to April 2018. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated aggregated using random effects models...
July 12, 2018: Annals of Medicine
Monika Uhrig, David Simons, Heinz-Peter Schlemmer
OBJECTIVES: Malignancy is the strongest predictor for venous thromboembolism. Dual energy CT (DECT) can support assessment of pulmonary emboli (PE) by providing vessel reconstructions (DECT-VR) and highlighting thrombi. Purpose was to determine prevalence and risk factors of PE in staging examinations of stage IV-melanoma patients and to evaluate the potential of DECT-VR to improve PE diagnosis. MATERIAL AND METHODS: This retrospective study was approved by IRB...
2018: PloS One
Jean-Marie Januel, Patrick S Romano, Chantal M Couris, Phil Hider, Hude Quan, Cyrille Colin, Bernard Burnand, William A Ghali
BACKGROUND: Routinely collected hospital data provide increasing opportunities to assess the performance of health care systems. Several factors may, however, influence performance measures and their interpretation between countries. OBJECTIVE: We compared the occurrence of in-hospital venous thromboembolism (VTE) in patients undergoing hip replacement across 5 countries and explored factors that could explain differences across these countries. METHODS: We performed cross-sectional studies independently in 5 countries: Canada; France; New Zealand; the state of California; and Switzerland...
July 11, 2018: Medical Care
Kazuko Sugiura, Toshiyuki Ojima, Tetsumei Urano, Takao Kobayashi
AIM: We analyzed the incidence and prognosis of thromboembolism associated with combined oral contraceptives (COCs) by age groups in Japan. METHODS: A total of 581 events of venous thromboembolism (VTE) and arterial thromboembolism (ATE) associated with COCs were analyzed from the Pharmaceuticals and Medical Devices Agency database from 2004 to 2013. In a statistical analysis, a good-prognosis group included recovery cases and a poor-prognosis group involved unrecovered cases with some sequela and fatal cases...
July 12, 2018: Journal of Obstetrics and Gynaecology Research
Hui Li, Gening Jiang, Servet Bölükbas, Chun Chen, Haiquan Chen, Keneng Chen, Jun Chen, Xiangli Cui, Wentao Fang, Shugeng Gao, Sebastien Gilbert, Jianhua Fu, Xiangning Fu, Yasuhiro Hida, Shanqing Li, Xiaofei Li, Yin Li, Hecheng Li, Yongjun Li, Deruo Liu, Lunxu Liu, Jianxing He, Jie He, Giuseppe Marulli, Hiroyuki Oizumi, Marc de Perrot, René Horsleben Petersen, Yaron Shargall, Alan Sihoe, Qunyou Tan, Qun Wang, Shun Xu, Mei Yang, Yuanhua Yang, Zhentao Yu, Lanjun Zhang, Xun Zhang, Heng Zhao, Xiuyi Zhi
No abstract text is available yet for this article.
May 2018: Journal of Thoracic Disease
Rachel M Landisch, Sheila J Hanson, Rowena C Punzalan, Kristin Braun, Laura D Cassidy, David M Gourlay
INTRODUCTION: Venous thromboembolism (VTE) is increasingly prevalent in injured children admitted to the intensive care unit (ICU). Few data exist to support VTE pharmacologic prophylaxis or ultrasound (US) surveillance in children with high bleeding risk. After implementation of screening US guidelines, we sought to describe our experience, hypothesizing that screening US of children at highest risk for VTE results in earlier detection and management. STUDY DESIGN: A retrospective analysis was conducted on prospectively collected data of injured children admitted to an American College of Surgeons Verified level 1 Pediatric Trauma Center from 2010 to 2015...
June 20, 2018: Journal of Pediatric Surgery
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