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2015-06-15

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cc-by (c) Mahé, Isabelle et al., 2015
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/175184

Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

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https://doi.org/10.1371/journal.pone.0128741

Resum

Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision.

Matèries

Tromboembolisme, Anticoagulants (Medicina), Càncer de ronyó

Matèries (anglès)

Thromboembolism, Anticoagulants (Medicine), Renal cancer

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Articles publicats en revistes (Ciències Clíniques)

Citació

MAHÉ, Isabelle, STERPU, Raluca, BERTOLETTI, Laurent, LÓPEZ JIMÉNEZ, Luciano, MELLADO JOAN, Meritxell, TRUJILLO SANTOS, Javier, BALLAZ, Aitor, HERNÁNDEZ BLASCO, Luis manuel, MARCHENA, Pablo javier, MONREAL, Manuel, RIETE investigadors. Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?. _PLoS Medicine_. 2015. Vol. 10, núm. 6, pàgs. e0128741. [consulta: 24 de gener de 2026]. ISSN: 1549-1277. [Disponible a: https://hdl.handle.net/2445/175184]

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