Risk factors of thrombotic recurrence and major bleeding in patients with intermediate-risk for recurrence of venous thromboembolism View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-07-06

AUTHORS

Yugo Yamashita, Hidewo Amano, Takeshi Morimoto, Kazushige Kadota, Reo Hata, Kazuki Matsushita, Kohei Osakada, Arata Sano, Toru Takase, Seiichi Hiramori, Kitae Kim, Maki Oi, Masaharu Akao, Yohei Kobayashi, Mamoru Toyofuku, Moriaki Inoko, Tomohisa Tada, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Yuji Nishimoto, Tomoki Sasa, Jiro Sakamoto, Minako Kinoshita, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Takao Kato, Koh Ono, Takeshi Kimura

ABSTRACT

Prolonged anticoagulation therapy is recommended for patients with intermediate-risk for recurrence of venous thromboembolism (VTE). The current study aimed to identify risk factors of VTE recurrence and major bleeding in intermediate-risk patients. The COMMAND VTE Registry is a multicenter registry enrolled consecutive 3027 patients with acute symptomatic VTE among 29 centers in Japan. The current study population consisted of 1703 patients with intermediate-risk for recurrence. The primary outcome measure was recurrent VTE during the entire follow-up period, and the secondary outcome measures were recurrent VTE and major bleeding during anticoagulation therapy. In the multivariable Cox regression model for recurrent VTE incorporating the status of anticoagulation therapy as a time-updated covariate, off-anticoagulation therapy was strongly associated with an increased risk for recurrent VTE (HR 9.42, 95% CI 5.97–14.86). During anticoagulation therapy, the independent risk factor for recurrent VTE was thrombophilia (HR 3.58, 95% CI 1.56–7.50), while the independent risk factors for major bleeding were age ≥ 75 years (HR 2.04, 95% CI 1.36–3.07), men (HR 1.52, 95% CI 1.02–2.27), history of major bleeding (HR 3.48, 95% CI 1.82–6.14) and thrombocytopenia (HR 3.73, 95% CI 2.04–6.37). Among VTE patients with intermediate-risk for recurrence, discontinuation of anticoagulation therapy was a very strong independent risk factor of recurrence during the entire follow-up period. The independent risk factors of recurrent VTE and those of major bleeding during anticoagulation therapy were different: thrombophilia for recurrent VTE, and advanced age, men, history of major bleeding, and thrombocytopenia for major bleeding.Clinical Trial RegistrationUnique identifier: UMIN000021132. COMMAND VTE Registry: http://www.umin.ac.jp/ctr/index.htm. More... »

PAGES

182-190

References to SciGraph publications

Journal

TITLE

Journal of Thrombosis and Thrombolysis

ISSUE

1

VOLUME

53

Author Affiliations

  • Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
  • Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
  • Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, 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, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 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, Faculty of Medicine, Kinki University, 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/s11239-021-02520-5

    DOI

    http://dx.doi.org/10.1007/s11239-021-02520-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1139433212

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34228248


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