Influence of baseline anemia on long-term clinical outcomes in patients with venous thromboembolism: from the COMMAND VTE registry View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-01-23

AUTHORS

Yugo Yamashita, Takeshi Morimoto, Hidewo Amano, Toru Takase, Seiichi Hiramori, Kitae Kim, Maki Oi, Masaharu Akao, Yohei Kobayashi, Mamoru Toyofuku, Toshiaki Izumi, Tomohisa Tada, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Syunsuke Saga, Tomoki Sasa, Jiro Sakamoto, Minako Kinoshita, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Hiroki Shiomi, Takao Kato, Takeru Makiyama, Koh Ono, Takeshi Kimura

ABSTRACT

The influence of anemia on the long-term clinical outcomes has not been fully evaluated in patients with venous thromboembolism (VTE). We evaluated the influence of anemia among 3012 patients in the COMMAND VTE Registry with a median follow-up period of 1219 days. The outcomes measures were ISTH major bleeding, recurrent VTE and all-cause death. There were 1012 patients (34%) with moderate/severe anemia (Hb ≤ 10.9 g/dl), 615 patients (20%) with mild anemia (Hb 11.0–12.9 g/dl for men, and 11.0–11.9 g/dl for women), and 1385 patients (46%) without anemia. The cumulative 5-year incidence of major bleeding was significantly higher in patients with anemia (moderate/severe anemia: 17.6%, mild anemia: 12.1%, and no anemia: 8.7%, P < 0.001). After adjusting the confounders, the excess risk of mild and moderate/severe anemia, respectively, relative to no anemia for major bleeding remained significant (mild: adjusted HR 1.41: [95% CI 1.00–1.98], P = 0.048; moderate/severe: adjusted HR 1.91: [95% CI 1.42–2.58], P < 0.001, respectively). The excess risk of moderate/severe anemia relative to no anemia was also significant for mortality (adjusted HR 2.89: 95% CI 2.45–3.42, P < 0.001), but the risk was neutral for recurrent VTE (adjusted HR 1.05: 95% CI 0.76–1.45, P = 0.77). In conclusions, VTE patients with mild and moderate/severe anemia had higher risk for major bleeding events without significant excess risk for recurrent VTE events, and the risk for major bleeding events increased according to the severity of anemia. We should pay more attention to the optimal intensity and duration of anticoagulation in VTE patients with anemia. More... »

PAGES

444-453

References to SciGraph publications

Journal

TITLE

Journal of Thrombosis and Thrombolysis

ISSUE

3

VOLUME

47

Author Affiliations

  • Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
  • Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
  • Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan
  • Department of Cardiology, Kinki University Hospital, Osaka, Japan
  • Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
  • Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
  • Department of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan
  • Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
  • Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan
  • Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
  • Cardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
  • Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
  • Department of Cardiology, Osaka Saiseikai Noe Hospital, Osaka, Japan
  • Department of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
  • Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan
  • Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
  • Department of Cardiology, Kishiwada City Hospital, Kishiwada, Japan
  • Department of Cardiology, Tenri Hospital, Tenri, Japan
  • Department of Cardiology, Nishikobe Medical Center, Kobe, Japan
  • Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan
  • Department of Cardiology, Koto Memorial Hospital, Higashiomi, Japan
  • Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11239-018-1791-2

    DOI

    http://dx.doi.org/10.1007/s11239-018-1791-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111615339

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30673941


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