Journal of thrombosis and haemostasis : JTH
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J. Thromb. Haemost. · Dec 2018
Multicenter Study Comparative StudyEvaluation of unfractionated heparin versus low-molecular-weight heparin and fondaparinux for pharmacologic venous thromboembolic prophylaxis in critically ill patients with cancer.
Essentials Critically ill cancer patients require pharmacologic prophylaxis for venous thromboembolism (VTE). Patients from 566 hospitals in the United States between 2010 and 2014 were included. Low-molecular-weight heparin (LMWH) prophylaxis was not associated in a reduction of VTE rates. ⋯ LMWH prophylaxis was associated with a reduction in pulmonary embolism (0.70% vs. 0.99%), significant bleeding (13.3% vs. 14.8%) and heparin-induced thrombocytopenia (HIT) (0.06% vs. 0.19%). In non-metastatic solid disease, LMWH was associated with decreased VTE (4.27% vs. 4.84%) and PE (0.47% vs. 0.95%). Conclusions The use of an LMWH for VTE prophylaxis was not associated with a reduction in the incidence of in-hospital VTE as compared with UFH, but was associated with significant reductions in PE, clinically important bleeding events, and incidence of HIT in critically ill patients with cancer.
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J. Thromb. Haemost. · Oct 2018
Multicenter StudyLongitudinal increases in blood biomarkers of inflammation or cardiovascular disease and the incidence of venous thromboembolism.
Essentials Inflammatory and cardiac diseases are associated with increased venous thromboembolism (VTE) risk. Our prospective study assessed rise in inflammatory or cardiac biomarkers and VTE risk. A greater 6-year rise in N-terminal natriuretic peptide is associated with increased VTE incidence. Volume overload or impending cardiac disease may contribute to VTE occurrence.
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J. Thromb. Haemost. · Sep 2018
Multicenter StudyRisk factors for bleeding, including platelet count threshold, in newly diagnosed immune thrombocytopenia adults.
Essentials Risk factors of bleeding in adult immune thrombocytopenia are not known. This multicenter study assessed risk factors of bleeding at immune thrombocytopenia onset. Platelet count thresholds associated with bleeding were < 20 × 109 L-1 and < 10 × 109 L-1. Exposure to anticoagulants was a major risk factor of severe bleeding.
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J. Thromb. Haemost. · Jul 2018
Multicenter Study Comparative StudyPrediction of short-term prognosis in elderly patients with acute pulmonary embolism: validation of the RIETE score.
Essentials The RIETE score was derived to predict 10-day adverse outcomes in acute pulmonary embolism (PE). We externally validated the RIETE score in a prospective cohort of patients with PE. The RIETE score classified fewer patients as low-risk than currently recommended scores. The RIETE score was not superior to other scores in predicting 10-day adverse outcomes.
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J. Thromb. Haemost. · Jun 2018
Randomized Controlled Trial Multicenter Study Comparative StudyClinically relevant bleeding in cancer patients treated for venous thromboembolism from the CATCH study.
Essentials Cancer patients receiving anticoagulants for venous thromboembolism have an elevated bleeding risk. This secondary analysis of CATCH assessed characteristics of clinically relevant bleeding (CRB). CRB occurs in 15% of cancer patients with thrombosis using therapeutic doses of anticoagulation. After multivariate analysis, risk factors for CRB were age >75 years and intracranial malignancy.