Publications by authors named "Bounameaux H"
Background: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.
Methods: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.
Direct oral anticoagulants (DOACs) provide a safe, effective alternative to vitamin K antagonists (VKAs) for venous thromboembolism (VTE) treatment, as shown via intention-to-treat comparative effectiveness analysis. However, on-treatment analysis is imperative in observational studies because anticoagulation choice and duration are at investigators' discretion. The aim of the study is to compare the effectiveness of DOACs and VKAs on 12-month outcomes in VTE patients using on-treatment analysis.
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- * The 2022 guidelines include specific treatments for patients with cancer and COVID-19, emphasizing low-molecular-weight heparins (LMWHs) and direct oral anticoagulants for managing blood clots.
- * Key recommendations highlight the use of LMWHs or direct oral anticoagulants for at least 6 months, extended post-surgery prophylaxis, and primary prevention in certain cancer patients undergoing treatment.
Background: Inferior vena cava (IVC) thrombosis is a rare form of venous thromboembolism (VTE). The optimal treatment strategies and outcomes are unclear in patients with this presentation.
Objective: We aimed to compare baseline characteristics, treatment patterns and 24-month outcomes in IVC thrombosis patients (n = 100) with lower extremity deep vein thrombosis (LEDVT) patients (n = 7629).
Article Synopsis
- There is limited understanding of how body mass index (BMI) affects outcomes in patients with venous thromboembolism (VTE), which this study aims to investigate.
- In the GARFIELD-VTE study, 10,869 patients were categorized by BMI and analyzed for differences in demographics, treatment, and 24-month health outcomes.
- Results indicated that underweight VTE patients face the highest mortality and bleeding risks, while obese patients had lower mortality risks compared to those with a normal BMI.
Article Synopsis
- This is the second update of the 9th edition guidelines, offering recommendations on 17 PICO questions, including four new ones that weren't addressed before.
- Using GRADE methodology, the panel created 29 guidance statements, 13 of which are strong recommendations related to managing antithrombotic treatment for VTE, including both initial and ongoing care.
- The update reflects new evidence since 2016, but it also highlights ongoing uncertainties in care for specific patient populations with limited disease.
Article Synopsis
- This text provides an update to the guidelines for managing venous thromboembolism (VTE), specifically the 2nd update of the 9th edition, which includes recommendations based on 17 PICO questions.
- Recommendations are created using the GRADE methodology, resulting in 29 guidance statements that include 13 strong recommendations focused on various aspects of VTE management.
- The update acknowledges that new evidence has emerged since the previous editions, but there are still significant uncertainties for certain management challenges, especially in special patient populations.
Introduction: Clinical characteristics and outcomes of venous thromboembolism (VTE) patients with concomitant anemia are unclear. This study compares baseline characteristics, treatment patterns, and 24-month outcomes in patients with and without anemia within GARFIELD-VTE.
Materials And Methods: GARFIELD-VTE (ClinicalTrials.
Provoked versus unprovoked venous thromboembolism: Findings from GARFIELD-VTE.
Res Pract Thromb Haemost
February 2021
Introduction: Venous thromboembolism (VTE) has a long-term risk of recurrence, dependent on the presence or absence of provoking risk factors at the time of the event.
Objective: To compare clinical characteristics, anticoagulant patterns, and 12-month outcomes in patients with transient provoking factors, active cancer, and unprovoked VTE.
Methods: The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE is a prospective, observational study that enrolled 10 207 patients with objectively diagnosed VTE from 415 sites in 28 countries.
Article Synopsis
- The study focuses on pregnancy-associated venous thromboembolism (PA-VTE), which is a significant cause of maternal mortality, examining women under 45 and comparing them to those with nonpregnancy-associated VTE (NPA-VTE).
- Women with PA-VTE were generally younger, had a lower incidence of pulmonary embolism, and a higher occurrence of left-sided deep vein thrombosis compared to NPA-VTE patients.
- Both groups used various treatments, including parenteral therapy and vitamin K antagonists, with similar rates of all-cause mortality, recurrent VTE, and major bleeding, though uterine bleeding was the most common complication overall.
Aims: Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation.
Methods And Results: We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE.
Importance: Patients with venous thromboembolism (VTE) and concomitant chronic kidney disease (CKD) have been reported to have a higher risk of thrombosis and major bleeding complications compared with patients without concomitant CKD. The use of anticoagulation therapy is challenging, as many anticoagulant medications are excreted by the kidney. Large-scale data are needed to clarify the impact of CKD for anticoagulant treatment strategies and clinical outcomes of patients with VTE.
View Article and Find Full Text PDFVenous thromboembolism (VTE) is common in cancer patients and is an important cause of morbidity and mortality. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE (ClinicalTrials.gov: NCT02155491) is a prospective, observational study of 10,684 patients with objectively diagnosed VTE from 415 sites in 28 countries.
View Article and Find Full Text PDFIntroduction: Randomized controlled trials have shown that direct oral anticoagulants (DOACs) are a safe and effective alternative to vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE). However, there are limited post-marketing data describing the effectiveness and safety of the DOACs in the community setting. We aimed to compare the effectiveness of DOACs and VKAs on 12-month outcomes in a real-world VTE patient population.
View Article and Find Full Text PDFBackground: Recent data have raised concerns about the risk/benefit ratio of thrombolysis in non-high risk pulmonary embolism patients due to increased serious bleeding events. Whether cardiac biomarkers could be of help for bleeding risk stratification in this setting remains elusive.
Objectives: To determine the prognostic accuracy of hs-cTnT, NT-proBNP, RIETE and PESI score for the occurrence of clinically relevant bleeding (CRB) in elderly patients under conventional anticoagulation therapy for non-massive pulmonary embolism (NMPE).
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at a high risk of VTE recurrence and bleeding during anticoagulant therapy. The International Initiative on Thrombosis and Cancer is an independent academic working group aimed at establishing a global consensus for the treatment and prophylaxis of VTE in patients with cancer.
View Article and Find Full Text PDFIsolated distal deep vein thrombosis (IDDVT) represents up to half of all lower limb DVT. This study investigated treatment patterns and outcomes in 2,145 patients with IDDVT in comparison with those with proximal DVT (PDVT; = 3,846) and pulmonary embolism (PE; = 4,097) enrolled in the GARFIELD-VTE registry. IDDVT patients were more likely to have recently undergone surgery (14.
View Article and Find Full Text PDFBackground: Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices.
View Article and Find Full Text PDFUpper extremity deep vein thrombosis (UEDVT) is less common than lower extremity DVT (LEDVT) and consequently less well characterized. This study compared clinical characteristics and 1-year outcomes between 438 UEDVT patients and 7,602 LEDVT patients recruited in the GARFIELD-VTE registry. UEDVT patients were significantly more likely to have a central venous catheter than those with LEDVT (11.
View Article and Find Full Text PDFBackground: Management of venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), varies worldwide.
Methods: The Global Anticoagulant Registry in the FIELD - Venous Thromboembolism (GARFIELD-VTE) is a prospective, observational study of 10,685 patients with objectively diagnosed VTE recruited from May 2014 to January 2017 at 417 sites in 28 countries. All patients are followed for at least 3 years.
Pregnancy can influence the development and progression of congenital arteriovenous malformations (AVM) and thus lead to life-threatening complications for the mother and fetus like high output cardiac failure and premature delivery. The simultaneous presence of a capillary malformation and AVM strongly suggests a RASA1 related disorder. Arteriovenous malformations, capillary malformation-arteriovenous malformation, capillaries/abnormalities, port-wine stain, pregnancy, RASA1 protein.
View Article and Find Full Text PDFCongenital arteriovenous malformations (AVM) represent a rare clinical entity. They are present at birth but can remain silent for many years. Due to their potential severity and their complex and specific management, the general practitioner should know when to suspect the presence of an AVM.
View Article and Find Full Text PDFBackground: Full- or lower-dose anticoagulant therapy or aspirin can be used for extended therapy in patients with venous thromboembolism (VTE), but information on their relative benefit-risk profiles is limited.
Methods: Data from the EINSTEIN-CHOICE trial were used to compare the benefit-risk profiles of extended treatment with rivaroxaban (20 or 10 mg once daily) and aspirin (100 mg once daily) in VTE patients who had completed 6 to 12 months of anticoagulation therapy. One-year cumulative incidences of recurrent VTE and major bleeding were estimated and benefits and risks were calculated by determining the between group differences in a hypothetical population of 10,000 VTE patients treated for 1 year.