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Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data

Background and objectives: Recurrence of venous thromboembolism (VTE) after a primary event is common; however, no sufficient risk scores have been widely introduced in clinical practice. The aim of this study was to assess the risk factors for VTE recurrences, as well as the effect of treatment str...

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Autores principales: Ģībietis, Valdis, Kigitoviča, Dana, Strautmane, Sintija, Meilande, Kitija, Kalējs, Verners Roberts, Zaičenko, Anastasija, Maķe, Kristīne, Lejnieks, Aivars, Skride, Andris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780231/
https://www.ncbi.nlm.nih.gov/pubmed/31438542
http://dx.doi.org/10.3390/medicina55090510
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author Ģībietis, Valdis
Kigitoviča, Dana
Strautmane, Sintija
Meilande, Kitija
Kalējs, Verners Roberts
Zaičenko, Anastasija
Maķe, Kristīne
Lejnieks, Aivars
Skride, Andris
author_facet Ģībietis, Valdis
Kigitoviča, Dana
Strautmane, Sintija
Meilande, Kitija
Kalējs, Verners Roberts
Zaičenko, Anastasija
Maķe, Kristīne
Lejnieks, Aivars
Skride, Andris
author_sort Ģībietis, Valdis
collection PubMed
description Background and objectives: Recurrence of venous thromboembolism (VTE) after a primary event is common; however, no sufficient risk scores have been widely introduced in clinical practice. The aim of this study was to assess the risk factors for VTE recurrences, as well as the effect of treatment strategies on the recurrence rate in a single-center patient cohort. Materials and Methods: The prospective cohort study included consecutive patients in a single center from June 2014 till June 2018 presenting with acute VTE confirmed by imaging tests. All patients were followed up for at least one year or till death. Statistical analyses were conducted using IBM SPSS Statistics 23 and Stata 13. Competing risk of death was considered. Results: A total of 219 eligible patients were identified during the study period. Pulmonary embolism with or without deep vein thrombosis (DVT) was present in 95.9% (n = 210), isolated DVT was present in 4.1% (n = 9) of patients. The total number of documented recurrences was 13 (5.9%). Incidence rate was 5.6 per 100 person-years. Recurrent VTE predicted significantly higher mortality rate (hazard ratio (HR) 6.64 [95% CI 2.61–16.93]). In univariate analysis, active cancer was associated with higher recurrence rate (p = 0.036). In competing-risks regression model (with death as the competing risk), active cancer (subdistribution hazard ratio (SHR) 2.11 (95% CI 0.58–7.76)) did not retain statistical significance for VTE recurrence. Discontinuation and duration of anticoagulant treatment (≤6 or >6 months), and drug class in acute or long-term therapy (parenteral, vitamin K antagonist (VKA), direct oral anticoagulant (DOAC)) were not associated with recurrences (p > 0.05). Conclusions: Patients who experienced recurrent VTE had 6.6-fold higher mortality rate than patients with no recurrences. The presence of active cancer was not a statistically significant risk factor for recurrence when taking into account the competing risk of death. Duration and drug class of anticoagulation did not seem to impact recurrence rate.
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spelling pubmed-67802312019-10-30 Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data Ģībietis, Valdis Kigitoviča, Dana Strautmane, Sintija Meilande, Kitija Kalējs, Verners Roberts Zaičenko, Anastasija Maķe, Kristīne Lejnieks, Aivars Skride, Andris Medicina (Kaunas) Article Background and objectives: Recurrence of venous thromboembolism (VTE) after a primary event is common; however, no sufficient risk scores have been widely introduced in clinical practice. The aim of this study was to assess the risk factors for VTE recurrences, as well as the effect of treatment strategies on the recurrence rate in a single-center patient cohort. Materials and Methods: The prospective cohort study included consecutive patients in a single center from June 2014 till June 2018 presenting with acute VTE confirmed by imaging tests. All patients were followed up for at least one year or till death. Statistical analyses were conducted using IBM SPSS Statistics 23 and Stata 13. Competing risk of death was considered. Results: A total of 219 eligible patients were identified during the study period. Pulmonary embolism with or without deep vein thrombosis (DVT) was present in 95.9% (n = 210), isolated DVT was present in 4.1% (n = 9) of patients. The total number of documented recurrences was 13 (5.9%). Incidence rate was 5.6 per 100 person-years. Recurrent VTE predicted significantly higher mortality rate (hazard ratio (HR) 6.64 [95% CI 2.61–16.93]). In univariate analysis, active cancer was associated with higher recurrence rate (p = 0.036). In competing-risks regression model (with death as the competing risk), active cancer (subdistribution hazard ratio (SHR) 2.11 (95% CI 0.58–7.76)) did not retain statistical significance for VTE recurrence. Discontinuation and duration of anticoagulant treatment (≤6 or >6 months), and drug class in acute or long-term therapy (parenteral, vitamin K antagonist (VKA), direct oral anticoagulant (DOAC)) were not associated with recurrences (p > 0.05). Conclusions: Patients who experienced recurrent VTE had 6.6-fold higher mortality rate than patients with no recurrences. The presence of active cancer was not a statistically significant risk factor for recurrence when taking into account the competing risk of death. Duration and drug class of anticoagulation did not seem to impact recurrence rate. MDPI 2019-08-21 /pmc/articles/PMC6780231/ /pubmed/31438542 http://dx.doi.org/10.3390/medicina55090510 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ģībietis, Valdis
Kigitoviča, Dana
Strautmane, Sintija
Meilande, Kitija
Kalējs, Verners Roberts
Zaičenko, Anastasija
Maķe, Kristīne
Lejnieks, Aivars
Skride, Andris
Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data
title Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data
title_full Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data
title_fullStr Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data
title_full_unstemmed Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data
title_short Venous Thromboembolism Recurrence in Latvian Population: Single University Hospital Data
title_sort venous thromboembolism recurrence in latvian population: single university hospital data
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780231/
https://www.ncbi.nlm.nih.gov/pubmed/31438542
http://dx.doi.org/10.3390/medicina55090510
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