Cargando…

Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study

Background: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therap...

Descripción completa

Detalles Bibliográficos
Autores principales: Yen, Chieh-Ching, Wang, Chih-Kai, Chaou, Chung-Hsien, Chen, Shou-Yen, Lin, Jhe-Ping, Ng, Chip-Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666632/
https://www.ncbi.nlm.nih.gov/pubmed/34912831
http://dx.doi.org/10.3389/fmed.2021.778198
_version_ 1784614251427528704
author Yen, Chieh-Ching
Wang, Chih-Kai
Chaou, Chung-Hsien
Chen, Shou-Yen
Lin, Jhe-Ping
Ng, Chip-Jin
author_facet Yen, Chieh-Ching
Wang, Chih-Kai
Chaou, Chung-Hsien
Chen, Shou-Yen
Lin, Jhe-Ping
Ng, Chip-Jin
author_sort Yen, Chieh-Ching
collection PubMed
description Background: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therapy in SI patients. Methods: We performed a multicenter retrospective cohort study of 86 SI patients. Patients were categorized as anticoagulant users and anticoagulant non-users. The associations between anticoagulant therapy, all-cause mortality, thromboembolic events and bleeding events were evaluated. Results: Forty-five patients (52.3%) received anticoagulant therapy during the follow-up periods. The all-cause mortality rate was 6.86 per 100 patient-years. Anticoagulant therapy was associated with 94% improved survival (HR = 0.06; Cl 0.007–0.48; p = 0.008), while the risk factors for all-cause mortality were prior stroke (HR = 13.15; Cl 2.39–72.27; p = 0.003) and liver cirrhosis (HR = 8.71; Cl 1.29–59.01; p = 0.027). Patients with anticoagulant therapy had a higher event-free survival curve for thromboembolic complications (p = 0.03) but did not achieve a significant difference after adjustment using the Cox regression model as a time-dependent covariate (HR = 0.57; Cl 0.13–2.45; p = 0.446). There was no significant difference in the risk of bleeding events between the groups (p = 0.728). Conclusions: Anticoagulant therapy in patients with SI was associated with better survival and was not related to an increased bleeding risk.
format Online
Article
Text
id pubmed-8666632
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-86666322021-12-14 Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study Yen, Chieh-Ching Wang, Chih-Kai Chaou, Chung-Hsien Chen, Shou-Yen Lin, Jhe-Ping Ng, Chip-Jin Front Med (Lausanne) Medicine Background: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therapy in SI patients. Methods: We performed a multicenter retrospective cohort study of 86 SI patients. Patients were categorized as anticoagulant users and anticoagulant non-users. The associations between anticoagulant therapy, all-cause mortality, thromboembolic events and bleeding events were evaluated. Results: Forty-five patients (52.3%) received anticoagulant therapy during the follow-up periods. The all-cause mortality rate was 6.86 per 100 patient-years. Anticoagulant therapy was associated with 94% improved survival (HR = 0.06; Cl 0.007–0.48; p = 0.008), while the risk factors for all-cause mortality were prior stroke (HR = 13.15; Cl 2.39–72.27; p = 0.003) and liver cirrhosis (HR = 8.71; Cl 1.29–59.01; p = 0.027). Patients with anticoagulant therapy had a higher event-free survival curve for thromboembolic complications (p = 0.03) but did not achieve a significant difference after adjustment using the Cox regression model as a time-dependent covariate (HR = 0.57; Cl 0.13–2.45; p = 0.446). There was no significant difference in the risk of bleeding events between the groups (p = 0.728). Conclusions: Anticoagulant therapy in patients with SI was associated with better survival and was not related to an increased bleeding risk. Frontiers Media S.A. 2021-11-29 /pmc/articles/PMC8666632/ /pubmed/34912831 http://dx.doi.org/10.3389/fmed.2021.778198 Text en Copyright © 2021 Yen, Wang, Chaou, Chen, Lin and Ng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Yen, Chieh-Ching
Wang, Chih-Kai
Chaou, Chung-Hsien
Chen, Shou-Yen
Lin, Jhe-Ping
Ng, Chip-Jin
Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_full Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_fullStr Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_full_unstemmed Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_short Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
title_sort anticoagulant therapy is associated with decreased long-term mortality in splenic infarction patients: a multicenter study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666632/
https://www.ncbi.nlm.nih.gov/pubmed/34912831
http://dx.doi.org/10.3389/fmed.2021.778198
work_keys_str_mv AT yenchiehching anticoagulanttherapyisassociatedwithdecreasedlongtermmortalityinsplenicinfarctionpatientsamulticenterstudy
AT wangchihkai anticoagulanttherapyisassociatedwithdecreasedlongtermmortalityinsplenicinfarctionpatientsamulticenterstudy
AT chaouchunghsien anticoagulanttherapyisassociatedwithdecreasedlongtermmortalityinsplenicinfarctionpatientsamulticenterstudy
AT chenshouyen anticoagulanttherapyisassociatedwithdecreasedlongtermmortalityinsplenicinfarctionpatientsamulticenterstudy
AT linjheping anticoagulanttherapyisassociatedwithdecreasedlongtermmortalityinsplenicinfarctionpatientsamulticenterstudy
AT ngchipjin anticoagulanttherapyisassociatedwithdecreasedlongtermmortalityinsplenicinfarctionpatientsamulticenterstudy