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Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study

Venous thromboembolism (VTE)‐BLEED, a decision tool for predicting major bleeding during chronic anticoagulation for VTE has not yet been validated in practice‐based conditions. We calculated the prognostic indices of VTE‐BLEED for major bleeding after day 30 and day 90, as well as for recurrent VTE...

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Autores principales: Klok, Frederikus A., Barco, Stefano, Turpie, Alexander G. G., Haas, Sylvia, Kreutz, Reinhold, Mantovani, Lorenzo G., Gebel, Martin, Herpers, Matthias, Bugge, Joerg‐Peter, Kostantinides, Stavros V., Ageno, Walter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283241/
https://www.ncbi.nlm.nih.gov/pubmed/30123981
http://dx.doi.org/10.1111/bjh.15533
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author Klok, Frederikus A.
Barco, Stefano
Turpie, Alexander G. G.
Haas, Sylvia
Kreutz, Reinhold
Mantovani, Lorenzo G.
Gebel, Martin
Herpers, Matthias
Bugge, Joerg‐Peter
Kostantinides, Stavros V.
Ageno, Walter
author_facet Klok, Frederikus A.
Barco, Stefano
Turpie, Alexander G. G.
Haas, Sylvia
Kreutz, Reinhold
Mantovani, Lorenzo G.
Gebel, Martin
Herpers, Matthias
Bugge, Joerg‐Peter
Kostantinides, Stavros V.
Ageno, Walter
author_sort Klok, Frederikus A.
collection PubMed
description Venous thromboembolism (VTE)‐BLEED, a decision tool for predicting major bleeding during chronic anticoagulation for VTE has not yet been validated in practice‐based conditions. We calculated the prognostic indices of VTE‐BLEED for major bleeding after day 30 and day 90, as well as for recurrent VTE and all‐cause mortality, in 4457 patients enrolled in the international, prospective XALIA study. The median at‐risk time was 190 days (interquartile range 106–360). The crude hazard ratio (HR) for major bleeding after day 30 was 2·6 [95% confidence interval (CI) 1·3–5·2] and the treatment‐adjusted HR was 2·3 (95% CI 1·1–4·5) for VTE‐BLEED high (versus low) risk patients: the corresponding values for major bleeding after day 90 were 3·8 (95% CI 1·6–9·3) and 3·2 (95% CI 1·3–7·7), respectively. The predictive value of VTE‐BLEED was similar in selected patients with unprovoked VTE or those treated with rivaroxaban. High VTE‐BLEED score was associated with higher incidence of all‐cause mortality (treatment‐adjusted HR 11, 95% CI 4·8–23), but not evidently with recurrent VTE (treatment‐adjusted HR 1·5; 95% CI 0·85–2·7). These results confirm the predictive value of VTE‐BLEED in practice‐based data in patients treated with rivaroxaban or conventional anticoagulation, supporting the hypothesis that VTE‐BLEED may be useful for making management decisions on the duration of anticoagulant therapy.
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spelling pubmed-62832412018-12-14 Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study Klok, Frederikus A. Barco, Stefano Turpie, Alexander G. G. Haas, Sylvia Kreutz, Reinhold Mantovani, Lorenzo G. Gebel, Martin Herpers, Matthias Bugge, Joerg‐Peter Kostantinides, Stavros V. Ageno, Walter Br J Haematol Platelets, Haemostasis and Thrombosis Venous thromboembolism (VTE)‐BLEED, a decision tool for predicting major bleeding during chronic anticoagulation for VTE has not yet been validated in practice‐based conditions. We calculated the prognostic indices of VTE‐BLEED for major bleeding after day 30 and day 90, as well as for recurrent VTE and all‐cause mortality, in 4457 patients enrolled in the international, prospective XALIA study. The median at‐risk time was 190 days (interquartile range 106–360). The crude hazard ratio (HR) for major bleeding after day 30 was 2·6 [95% confidence interval (CI) 1·3–5·2] and the treatment‐adjusted HR was 2·3 (95% CI 1·1–4·5) for VTE‐BLEED high (versus low) risk patients: the corresponding values for major bleeding after day 90 were 3·8 (95% CI 1·6–9·3) and 3·2 (95% CI 1·3–7·7), respectively. The predictive value of VTE‐BLEED was similar in selected patients with unprovoked VTE or those treated with rivaroxaban. High VTE‐BLEED score was associated with higher incidence of all‐cause mortality (treatment‐adjusted HR 11, 95% CI 4·8–23), but not evidently with recurrent VTE (treatment‐adjusted HR 1·5; 95% CI 0·85–2·7). These results confirm the predictive value of VTE‐BLEED in practice‐based data in patients treated with rivaroxaban or conventional anticoagulation, supporting the hypothesis that VTE‐BLEED may be useful for making management decisions on the duration of anticoagulant therapy. John Wiley and Sons Inc. 2018-08-19 2018-11 /pmc/articles/PMC6283241/ /pubmed/30123981 http://dx.doi.org/10.1111/bjh.15533 Text en © 2018 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd and British Society for Haematology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Platelets, Haemostasis and Thrombosis
Klok, Frederikus A.
Barco, Stefano
Turpie, Alexander G. G.
Haas, Sylvia
Kreutz, Reinhold
Mantovani, Lorenzo G.
Gebel, Martin
Herpers, Matthias
Bugge, Joerg‐Peter
Kostantinides, Stavros V.
Ageno, Walter
Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study
title Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study
title_full Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study
title_fullStr Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study
title_full_unstemmed Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study
title_short Predictive value of venous thromboembolism (VTE)‐BLEED to predict major bleeding and other adverse events in a practice‐based cohort of patients with VTE: results of the XALIA study
title_sort predictive value of venous thromboembolism (vte)‐bleed to predict major bleeding and other adverse events in a practice‐based cohort of patients with vte: results of the xalia study
topic Platelets, Haemostasis and Thrombosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283241/
https://www.ncbi.nlm.nih.gov/pubmed/30123981
http://dx.doi.org/10.1111/bjh.15533
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