Introduction: Approximately 10 % of all diagnosed pulmonary embolism are isolated to the subsegmental vessels. The risk of recurrent venous thromboembolism (VTE) in patients with an acute subsegmental pulmonary embolism (SSPE) managed with or without anticoagulant therapy remains poorly understood.
Methods: This is an observational cohort study including consecutive adult patients diagnosed with acute isolated SSPE between June 01, 2019, and August 31, 2022. We excluded patients with a concomitant diagnosis of deep vein thrombosis and those who had an indication for long-term anticoagulation. The primary outcome was objectively confirmed recurrent VTE.
Results: Overall, 118 patients with acute SSPE were included in the analysis. The mean (± standard deviation [SD]) age of the participants was 59 ± 17 years and 44 % of them had active cancer. Mean (±SD) duration of follow-up was 438 ± 426 days. Seventy-seven patients (65 %) were initially treated with anticoagulation, whereas 41 patients (35 %) were not. Of the 77 patients receiving anticoagulant therapy, 23 (30 %) received extended-duration anticoagulation (beyond 3 months) for secondary prevention. Overall, recurrent VTE events occurred in 6/118 (5 %, 95 % CI 2.4 to 10.7) patients. Four events (4/77 = 5.2 %, 95 % CI 2.0 to 12.6) occurred in initially treated patients. Two recurrent VTE occurred in patients initially left untreated (2/41 = 4.9 %, 95 % CI 1.4 to 16.1). Half of the recurrent VTE occurred in patients with active cancer.
Conclusions: Most patients diagnosed with an acute SSPE received anticoagulation. The incidence of recurrent VTE detected over time was relatively high, especially in patients with cancer.
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http://dx.doi.org/10.1016/j.thromres.2024.109037 | DOI Listing |
Thromb Haemost
December 2024
Department of Obstetrics, Gynaecology and Perinatal Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Background: In young women with venous thromboembolism (VTE) related to weak transient risk factors, it remains unknown whether stress levels and intimate partner violence (IPV) are associated with recurrence. The VTE-WEAK study aims to investigate the association between perceived stress and IPV with a recurrence of VTE in women with a first episode of VTE due to combined oral contraceptives, pregnancy-puerperium, minor trauma/fracture, brief surgery, infection or brief immobility, and not using antithrombotic prophylaxis.
Material And Methods: We performed a multicenter, international, observational, retrospective study on women referred for thrombophilia screening who were subsequently monitored.
Cardiovasc Hematol Agents Med Chem
December 2024
Department of Pharmacy Practice, JKKN College of Pharmacy, Namakkal, India.
Direct Oral Anticoagulants (DOACs) have transformed the management of thrombotic disorders, offering a more convenient and effective alternative to traditional vitamin K antagonists (VKAs). However, assessing thrombotic risk in patients treated with DOACS remains crucial due to the potential for recurrent events. Current clinical risk scores have limitations in predicting and monitoring venous thromboembolism (VTE) risk in specific DOAC populations.
View Article and Find Full Text PDFJ Thromb Haemost
December 2024
C2VN, INSERM, INRAE, Aix Marseille Univ, Marseille, France; Laboratory of Haematology, La Timone Hospital, Marseille, France. Electronic address:
Background: Although heritability of venous thromboembolism (VTE) is high, the thrombophilia screening appears to be positive only in a minority of VTE patients. Adding rare variants screening to identify VTE missing heritability still requires further assessment.
Objective: We report the results of a panel strategy after 3 years of application.
Background: Managing cancer associated thrombosis (CAT) is a significant clinical challenge due to several factors such as increased bleeding tendency, frailty, and drug - drug interactions. For many years, the drug of choice for treating CAT was low molecular weight heparin (LMWH); Recently, direct oral anticoagulants (DOACs) entered to the therapeutic milieu of CAT. However, due to the large diversity among patients with CAT in clinical and laboratory characteristics not all patients will equally benefit from treatment with DOACs.
View Article and Find Full Text PDFMed Clin (Barc)
December 2024
Venous Thromboembolism Unit of Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain; School of Medicine, University Complutense of Madrid, Spain; Sanitary Research Institute Gregorio Marañón, Madrid, Spain.
Background: The role of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in the treatment of venous thromboembolism (VTE) in patients with antiphospholipid syndrome remains uncertain.
Methods: We conducted a prospective observational study on APS patients with VTE treated with VKAs or DOACs in a tertiary hospital from 2010 to 2023. Clinical characteristics, recurrent arterial or VTE events, and hemorrhagic complications were analyzed over a one-year follow-up.
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