Long‐term risk of recurrent venous thromboembolism after a first contraceptive‐related event: Data from REVERSE cohort study

2021 ◽  
Author(s):  
David Aziz ◽  
Leslie Skeith ◽  
Marc A. Rodger ◽  
Elham Sabri ◽  
Marc Righini ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Event Data ◽  
Related Event ◽  
Recurrent Venous Thromboembolism

Treatment and Long-Term Clinical Outcomes of Incidental Pulmonary Embolism in Patients With Cancer: An International Prospective Cohort Study

2019 ◽  
Vol 37 (20) ◽  
pp. 1713-1720 ◽  
Author(s):  
Noémie Kraaijpoel ◽  
Suzanne M. Bleker ◽  
Guy Meyer ◽  
Isabelle Mahé ◽  
Andrés Muñoz ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Clinical Outcomes ◽  
Major Bleeding ◽  
Cumulative Incidence ◽  
Patients With Cancer ◽  
Incidental Pulmonary Embolism ◽  
Recurrent Venous Thromboembolism

PURPOSE Pulmonary embolism is incidentally diagnosed in up to 5% of patients with cancer on routine imaging scans. The clinical relevance and optimal therapy for incidental pulmonary embolism, particularly distal clots, is unclear. The aim of the current study was to assess current treatment strategies and the long-term clinical outcomes of incidentally detected pulmonary embolism in patients with cancer. PATIENTS AND METHODS We conducted an international, prospective, observational cohort study between October 22, 2012, and December 31, 2017. Unselected adults with active cancer and a recent diagnosis of incidental pulmonary embolism were eligible. Outcomes were recurrent venous thromboembolism, major bleeding, and all-cause mortality during 12 months of follow-up. Outcome events were centrally adjudicated. RESULTS A total of 695 patients were included. Mean age was 66 years and 58% of patients were male. Most frequent cancer types were colorectal (21%) and lung cancer (15%). Anticoagulant therapy was initiated in 675 patients (97%), of whom 600 (89%) were treated with low-molecular-weight heparin. Recurrent venous thromboembolism occurred in 41 patients (12-month cumulative incidence, 6.0%; 95% CI, 4.4% to 8.1%), major bleeding in 39 patients (12-month cumulative incidence, 5.7%; 95% CI, 4.1% to 7.7%), and 283 patients died (12-month cumulative incidence, 43%; 95% CI, 39% to 46%). The 12-month incidence of recurrent venous thromboembolism was 6.4% in those with subsegmental pulmonary embolism compared with 6.0% in those with more proximal pulmonary embolism (subdistribution hazard ratio, 1.1; 95% CI, 0.37 to 2.9; P = .93). CONCLUSION In patients with cancer with incidental pulmonary embolism, risk of recurrent venous thromboembolism is significant despite anticoagulant treatment. Patients with subsegmental pulmonary embolism seemed to have a risk of recurrent venous thromboembolism comparable to that of patients with more proximal clots.

scholarly journals Long-term recurrence of venous thromboembolism after short-term treatment of symptomatic isolated distal deep vein thrombosis: A cohort study

2017 ◽  
Vol 22 (6) ◽  
pp. 518-524 ◽  
Author(s):  
Marco P Donadini ◽  
Francesco Dentali ◽  
Samuela Pegoraro ◽  
Fulvio Pomero ◽  
Chiara Brignone ◽  
...  
Keyword(s):  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Term Treatment ◽  
Short Term ◽  
Short Term Treatment ◽  
Vein Thrombosis ◽  
Recurrent Vte ◽  
Deep Vein

Isolated distal deep vein thrombosis (IDDVT) is a common clinical manifestation of venous thromboembolism (VTE). However, there are only scant and heterogeneous data available on the long-term risk of recurrent VTE after IDDVT, and the optimal therapeutic management remains uncertain. We carried out a retrospective cohort study of consecutive patients diagnosed with symptomatic IDDVT between 2004 and 2011, according to a predefined short-term treatment protocol (low molecular weight heparin (LMWH) for 4–6 weeks). The primary outcome was the occurrence of recurrent VTE. A total of 321 patients were enrolled. IDDVT was associated with a transient risk factor or cancer in 165 (51.4%) and 56 (17.4%) patients, respectively. LMWH was administered for 4–6 weeks to 280 patients (87.2%), who were included in the primary analysis. Overall, during a mean follow-up of 42.3 months, 42 patients (15%) developed recurrent VTE, which occurred as proximal DVT or PE in 21 cases. The recurrence rate of VTE per 100 patient-years was 3.5 in patients with transient risk factors, 7.2 in patients with unprovoked IDDVT, and 5.9 in patients with cancer ( p=0.018). At multivariable analysis, unprovoked IDDVT and previous VTE were significantly associated with recurrent VTE (HR 2.16, 95% CI 1.12–4.16 and HR 1.97, 95% CI 1.01–3.86, respectively). In conclusion, the long-term risk of recurrent VTE after IDDVT treated for 4–6 weeks is not negligible, in particular in patients with unprovoked IDDVT or cancer. Further studies are needed to clarify whether a longer, but definite treatment duration effectively prevents these recurrences.

Long-Term, Low-Intensity Warfarin Therapy for the Prevention of Recurrent Venous Thromboembolism

2003 ◽  
Vol 348 (15) ◽  
pp. 1425-1434 ◽  
Author(s):  
Paul M Ridker ◽  
Samuel Z. Goldhaber ◽  
Ellie Danielson ◽  
Yves Rosenberg ◽  
Charles S. Eby ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Warfarin Therapy ◽  
Low Intensity ◽  
Recurrent Venous Thromboembolism

scholarly journals Statin therapy and recurrent venous thromboembolism in the elderly: a prospective cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Regula Monika Kronenberg ◽  
Shanthi Beglinger ◽  
Odile Stalder ◽  
Marie Méan ◽  
Andreas Limacher ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Propensity Scores ◽  
The Elderly ◽  
Confounding By Indication ◽  
Multicentre Cohort Study ◽  
Recurrent Venous Thromboembolism ◽  
Reduce Risk ◽  
Multicentre Cohort

Abstract Previous studies reported lower rates of recurrent venous thromboembolism (rVTE) among statin users, but this association could be influenced by concurrent anticoagulation and confounding by statin indication. This study aimed to confirm the beneficial association between statins and rVTE, stratified according to periods with and without anticoagulation, and additionally employ propensity score weighted approach to reduce risk of confounding by indication. The setting was a prospective multicentre cohort study and the outcome was time to first rVTE in statin vs. non-statin users. 980 participants with acute VTE were enrolled (mean age 75.0 years, 47% women), with median follow-up of 2.5 years. Of 241 (24.3%) statin users, 21 (8.7%) suffered rVTE vs. 99 (13.4%) among 739 non-users. The overall adjusted sub-hazard ratio (aSHR) for rVTE comparing statin users to non-users was 0.72 (95%CI 0.44 to 1.19, p = 0.20). This association was only apparent during periods without anticoagulation (aSHR 0.50, 95%CI 0.27 to 0.92, p = 0.03; vs. with anticoagulation: aSHR 1.34, 95%CI 0.54 to 3.35, p = 0.53). Using propensity scores, the rVTE risk during periods without anticoagulation fell further (aSHR 0.20, 95%CI 0.08 to 0.49, p < 0.001). In conclusion, statin use is associated with a more pronounced risk reduction for rVTE than previously estimated, but only during periods without anticoagulation.

Comparison of Low-Intensity Warfarin Therapy With Conventional-Intensity Warfarin Therapy for Long-Term Prevention of Recurrent Venous Thromboembolism

2004 ◽  
Vol 59 (2) ◽  
pp. 78-80
Author(s):  
Clive Kearon ◽  
Jeffrey S. Ginsberg ◽  
Michael J. Kovacs ◽  
David R. Anderson ◽  
Philip Wells ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Warfarin Therapy ◽  
Low Intensity ◽  
Recurrent Venous Thromboembolism

Anticoagulation after venous thromboembolism

2013 ◽  
Vol 33 (03) ◽  
pp. 211-217 ◽  
Author(s):  
S. Eichinger
Keyword(s):  
Venous Thromboembolism ◽  
Prediction Models ◽  
Oral Anticoagulants ◽  
Bleeding Risk ◽  
Patient Characteristics ◽  
Recurrence Risk ◽  
Recurrence Rates ◽  
Clinical Patient ◽  
Recurrent Venous Thromboembolism

SummaryDeciding on the optimal duration of anticoagulation is based on the risk of recurrent venous thromboembolism (VTE) and of bleeding during anticoagulation. The duration of anticoagulation should be at least three months since shorter courses double the recurrence rates.At three months anticoagulation can be stopped in patients with a VTE provoked by a transient risk factor, as the recurrence risk is expected to be lower than the bleeding risk during anticoagulation. Patients with unprovoked VTE are at higher risk of recurrence and prolonged anticoagulation is currently recommended.However, attempts are made to stratify these patients according to their recurrence risk and to identify those with a low recurrence risk who would not benefit from extended anticoagulation. Novel approaches to optimize the management of patients with unprovoked VTE are the use of prediction models which link clinical patient characteristics with laboratory testing to discriminate between patients with a low risk (who may discontinue anticoagulation) and those with high risk (in whom long term anticoagulation is justified). Moreover, new antithrombotic concepts including new oral anticoagulants or aspirin both of which potentially confer a lower bleeding risk and are more convenient for the patients have been explored for extended thromboprophylaxis.

scholarly journals Statin treatment and risk of recurrent venous thromboembolism: a nationwide cohort study

BMJ Open ◽  
2013 ◽  
Vol 3 (11) ◽  
pp. e003135 ◽  
Author(s):  
Cu Dinh Nguyen ◽  
Charlotte Andersson ◽  
Thomas Bo Jensen ◽  
Anne Gjesing ◽  
Anne-Marie Schjerning Olsen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
Statin Treatment ◽  
Recurrent Venous Thromboembolism
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