1,721,195 research outputs found
Duration of anticoagulation and risk of recurrent thromboembolism in carriers of factor V Leiden or prothrombin mutation
No full textJ Thromb Haemost. 2008 Dec;6(12):2223-4. Epub 2008 Oct 1.
Duration of anticoagulation and risk of recurrent thromboembolism in carriers of
factor V Leiden or prothrombin mutation.
Prandoni P, Tormene D, Spiezia L, Pesavento R, Simioni P.
Comment in
J Thromb Haemost. 2008 Dec;6(12):2225-6.
PMID: 18983490 [PubMed - indexed for MEDLINE
Thrombophilia as a predictor of persistent residual vein thrombosis
No full textHaematologica. 2008 Mar;93(3):479-80.
Thrombophilia as a predictor of persistent residual vein thrombosis.
Spiezia L, Tormene D, Pesavento R, Salmaso L, Simioni P, Prandoni P.
To compare the probability of leg vein recanalization between carriers and
non-carriers of thrombophilia after an episode of deep vein thrombosis (DVT) of
the lower extremities, we reviewed the clinical records of 472 patients with
proximal DVT who were diagnosed with thrombophilia, and had long-term ultrasound
scanning. One hundred and thirty-seven patients (29.0%) were carriers of
thrombophilia. After adjusting for age, sex, DVT localization and modality of
presentation, the hazard ratio of vein recanalization in thrombophilic compared
with non-thrombophilic patients was 0.49 (95% CI, 0.38 to 0.63). These findings
suggest that thrombophilia is an independent predictor of persistent residual
vein thrombosis.
PMID: 18310547 [PubMed - indexed for MEDLINE
Use of rivaroxaban in real-life treatment of venous thromboembolism: Results of the TEV Survey, an Italian Epidemiological Study
No full textBackground. Rivaroxaban is a direct and selective inhibitor of factor Xa. The randomized clinical trials EINSTEIN evaluated the efficacy and safety of rivaroxaban for the treatment of venous thromboembolism (VTE) proving that the drug was non-inferior to standard treatment. The aim of this survey was to describe how rivaroxaban was used in a group of "real-life" patients with VTE. Methods. Between June and October 2014, physicians collected aggregate data, through an online questionnaire, on consecutive patients affected by VTE and treated with rivaroxaban in the previous 6 months. Descriptive statistics were performed on the collected data. Results. A total of 345 questionnaires were filled out. The mean age of patients was 62 years, with a low prevalence of concomitant diseases and/or pharmacological treatments. Deep vein thrombosis was diagnosed in 90[%] of patients and pulmonary embolism in 47[%]; only 48[%] was hospitalized. Rivaroxaban was prescribed at the recommended doses and/or regimen in no more than 60[%] of cases. In 96[%] of patients, the initial therapeutic plan did not require changes. Adherence to the therapeutic plan and overall patient satisfaction with therapy were high. Conclusions. Rivaroxaban was found easy to use and was highly appreciated by patients
Prevention and treatment of the chronic thromboembolic pulmonary hypertension
No full textChronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon and late complication of pulmonary embolism resulting from misguided remodelling of residual pulmonary thromboembolic material and small-vessel arteriopathy. CTEPH is the only form of pulmonary hypertension (PH) potentially curable by pulmonary endarterectomy (PEA). Unfortunately, several patients have either an unacceptable risk-benefit ratio for undergoing the surgical intervention or develop persistent PH after PEA. Novel medical and endovascular therapies can be considered for them. The soluble guanylate cyclase stimulator riociguat is recommended for the treatment of patients with inoperable disease or with recurrent/persistent PH after PEA. Other drugs developed for the treatment of other forms of PH, as prostanoids, phosphodiesterase-5 inhibitors and endothelin receptor antagonists have been used in the treatment of CTEPH, with limited benefit. Balloon pulmonary angioplasty is a novel and promising technique and is progressively emerging from the pioneering phase. Highly specialized training level and complex protocols of postoperative care are mandatory to consolidate the technical success of the surgical and endovascular intervention
Heart disease in patients with pulmonary embolism
No full textPurpose of review: Several heart diseases are promoters of left-side cardiac thrombosis and could lead to arterial embolism. The same mechanism may be responsible for right-side cardiac thrombosis and therefore be a direct source of pulmonary embolism. Recent findings: Yasuoka et al. showed a higher incidence of perfusion defects in lung scan in patients with spontaneous echocontrast in the right atrium than in those without it (40% and 7% respectively; P = 0.006). We recently assessed the prevalence of heart diseases in 11.236 consecutive patients older than 60 years discharged from Venetian hospitals with a diagnosis of pulmonary embolism. We observed a higher prevalence of all-cause heart diseases (odds ratio 1.26; 95% confidence interval, 1.13-1.40) in patients with a diagnosis of pulmonary embolism alone (secondary or unprovoked) compared with those discharged with a diagnosis of pulmonary embolism associated with deep vein thrombosis, generating the hypothesis that some specific heart diseases in older patients could themselves be a possible source of pulmonary emboli. Summary: Further prospective studies are required to confirm these findings, which have the potential to open new horizons for the interpretation and management of venous thromboembolic disease. © 2010 Wolters Kluwer Health | Lippincott Williams and Wilkins
High vs. low doses of low-molecular-weight heparin for the treatment of superficial vein thrombosis of the legs: a double-blind, randomized trial
No full textI.F.=5.13
The optimal duration of anticoagulant therapy after unprovoked venous thromboembolism – Still a challenging issue
No full textAs about 50 % of patients with unprovoked venous thromboembolism (VTE) will develop new episodes after discontinuing therapy, indefinite treatment is suggested in patients with low or moderate bleeding risk. Baseline and post-baseline factors can help clinicians to identify patients at high risk of recurrence, who require extended treatment. Residual vein obstruction and D-dimer assay have been shown to be suitable methods for assessing the risk of VTE recurrences after a first unprovoked VTE. In treatment for VTE the use of direct oral anticoagulants (DOAC) is growing instead of the standard adjusted dose of vitamin K antagonists. The DOAC safety profile has recently been strengthened with systematic reviews and meta-analyses. Idarucizumab is only approved for the reversal of dabigatran etexilate; intravenous antidotes for factor Xa inhibitors are under development. Their advent is of great interest. In the extended treatment of VTE sulodexide has been demonstrated to significantly decrease the risk of recurrences with an excellent safety profile. Aspirin is substantially less effective than oral anticoagulants in preventing recurrences but could play a role among patients who decided to stop anticoagulants. In conclusion, for the secondary prevention of VTE several options are available, without a recognised best choice regarding the treatment duration and the choice of drugs. An individual strategy taking into account risk of recurrence, bleeding risk, therapeutic options, and patient preferences is appropriate
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